Progression of Type C Chronic Hepatitis to Liver Cirrhosis and Hepatocellular Carcinoma—Its Relationship to Alcohol Drinking and the Age of Transfusion


Harumasa Yoshihara, M.D., Ph.D., Department of Gastroenterology, Osaka Rosai Hospital, 1179–3 Nagasone-cho, Sakai, Osaka 591, Japan.


Alcohol drinking has been reported to be an important factor that modulates the development and prognosis of chronic hepatitis B; however, little is known about an interrelationship between alcohol intake and the progression of chronic hepatitis C to liver cirrhosis (LC) and hepatocellular carcinoma (HCC). We attempted to clarify this interrelationship in patients with hepatitis C and history of blood transfusion. Thirty LC and 85 HCC patients were enrolled. In patients with LC, no significant correlation was observed between the amount of alcohol intake and the period from transfusion to diagnosis. The period from transfusion to diagnosis in HCC patients with alcohol intake ≥46 g/day and < 46 g/day were 26 ± 6 and 31 ± 9 years, respectively, resulting in a significant difference (p < 0.05). The period from transfusion to diagnosis of LC and/or HCC showed significant negative correlation with the age of transfusion (r= 0.82, Y = -0.67X+ 48.0, p < 0.01; r= 0.76, Y= -0.70X+ 54.1, p < 0.001, respectively). This correlation was also observed in patients with HCC, regardless of the amount of alcohol intake. In conclusion, these data suggest that alcohol drinking might be an important factor that promotes an occurrence of HCC in patients with hepatitis C, and that hepatitis C virus infection in the elderly promotes development of liver disease via LC to HCC.