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Hepatitis C and alcohol.

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  • claudine intexas
    J Hepatol 1999;31 Suppl 1:113-8 Hepatitis C and alcohol. Degos F Service d hepatologie, Hopital Beaujon, Clichy, France. francoise.degos@bjn.ap-hop-paris.fr A
    Message 1 of 1 , Jun 25, 2001
      J Hepatol 1999;31 Suppl 1:113-8

      Hepatitis C and alcohol.

      Degos F

      Service d'hepatologie, Hopital Beaujon, Clichy,
      France.
      francoise.degos@...-hop-paris.fr

      A close relationship and possible interaction has been
      noted between
      alcohol
      intake and hepatitis C virus infection, since the
      discovery of HCV
      markers.
      It is not understood whether these are additive or
      synergistic effects
      in
      causing liver injury. Interactions between alcohol and
      HCV may be
      studied at
      several levels, including epidemiology, virology
      (including viral
      load),
      histology (effect on the severity of liver lesions),
      carcinogenesis
      (the
      role of alcohol in the occurrence of hepatocellular
      carcinoma), and the
      effect on the extrahepatic manifestations or severity
      of HCV infection.
      At
      the epidemiological level, a high prevalence of HCV
      infection was noted
      in
      patients with alcoholic liver diseases (14-37%), also
      characterized by
      a
      high rate of viral replication as detected by PCR,
      which was present in
      over
      90% of patients tested. Moreover, the prevalence of
      anti-HCV antibodies
      increased proportionally with the severity of liver
      lesions.
      Virological
      analysis based on the determination of HCV RNA levels
      in the serum
      showed
      variations of HCV RNA levels with diet, and a clear
      relationship
      between
      self reported alcohol consumption and the levels of
      serum HCV RNA (r =
      .26,
      p = .001). At the histologic level the role of alcohol
      may be evaluated
      either through the development of fibrosis or by
      determination of the
      incidence of cirrhosis. A study on the effect of
      alcohol intake below
      or
      over 40 g per day on the histologic progression of
      liver lesions has
      confirmed a more rapid increase in fibrosis and a
      doubling in the
      incidence
      of cirrhosis in patients admitting to alcohol
      consumption >40 g per
      day. The
      role of alcohol in the occurrence of hepatocellular
      carcinoma in
      patients
      with cirrhosis due to HCV infection has been
      extensively studied with
      controversial results. A recent case control study
      performed in Italy
      showed
      that the relative risk of HCC in patients with HCV
      infection and heavy
      alcohol consumption doubled. Finally, alcohol
      consumption potentially
      worsens the evolution of dermatological diseases
      associated with HCV
      infection such as porphyria cutanea tarda. All of the
      above are strong
      arguments which should be used to advise HCV patients
      against alcohol
      consumption, regardless of the degree of liver injury.
      However, the
      deleterious effect of the occasional intake of small
      amounts of alcohol
      has
      not been demonstrated and therefore an occasional
      drink may be allowed
      in
      some cases.

      Publication Types:
      Review
      Review, tutorial



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