Copyright 2002 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2002
The suggestions by Drs Giannini and Testa are interesting. Our study shows that smoking and drinking alcohol are independently associated with elevated ALT levels among anti-HCV–positive individuals, and we strongly suggest that to reduce the possible risk of aggravating liver dysfunction, anti-HCV–positive patients should not smoke or drink alcohol.1 Cigarette smoking is related not only to elevated ALT levels, but also to increased severity of hepatic fibrosis in anti-HCV–positive patients.2 Treatment for chronic hepatitis C is recommended for patients with persistently elevated ALT levels, but there is no rationale for treating anti-HCV–positive patients with normal ALT levels. It is therefore plausible to suggest to anti-HCV–positive subjects that they abstain from smoking, especially those with elevated ALT levels and those who seek anti-HCV treatment.
Wang C, Wang S, Chang T, Yao W, Chou P. Can Changing Counseling Strategy Change the Picture of the Chronic Hepatitis C Patient Population?—Reply. Arch Intern Med. 2002;162(21):2497. doi: