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April 26, 1993

Hepatitis C Virus Antibody in Alcoholic Patients: Association With the Presence of Portal and/or Lobular Hepatitis

Author Affiliations

From the Alcohol Research and Treatment Center and Laboratory Service, Bronx Veterans Affairs Medical Center (Drs Rosman, Paronetto, and Lieber and Ms Galvin and Mr Williams), and Mount Sinai School of Medicine (Drs Rosman, Paronetto, and Lieber), Bronx, NY.

Arch Intern Med. 1993;153(8):965-969. doi:10.1001/archinte.1993.00410080031005

Objective:  To evaluate the relationship between hepatitis C viral infection and alcoholic liver disease.

Design:  Case-comparison study.

Setting:  Bronx (NY) Veterans Affairs Medical Center.

Participants:  Forty-seven consecutive alcoholic patients undergoing diagnostic liver biopsy.

Main Outcome Measures:  Serum was obtained at the time of liver biopsy and assayed for antibodies to hepatitis C virus using enzyme-linked immunosorbent assay, recombinant immunoblot assay, and hepatitis C virus neutralization methods.

Results:  Antibody to hepatitis C virus, as confirmed by the recombinant immunoblot assay, was strongly associated with the presence of portal and/or lobular inflammation (91% seropositivity) but was only present in 16% of patients without this histologic finding (P<.001). In patients without portal or lobular hepatitis, recombinant immunoblot assay seropositivity was seen in 27% of patients with cirrhosis and 20% of patients with alcoholic hepatitis and was absent in patients with steatosis and/or perivenular fibrosis. In the subgroup of alcoholic patients who were without known risk factors for hepatitis C virus infection (ie, no history of intravenous drug use or blood transfusions), antibody to hepatitis C virus was present in 78% of subjects with portal and/or lobular hepatitis but was absent in those with other types of alcoholic liver disease. Finally, anti—hepatitis C virus—seropositive patients had a significantly greater mean necroinflammatory score as compared with anti—hepatitis C virus— seronegative alcoholic patients (2.1 vs 1.2; P<.001). In contrast, there was no significant difference in the mean fibrosis score between the two groups.

Conclusions:  The presence of portal and/or lobular inflammation is strongly associated with antibodies to hepatitis C virus in alcoholic patients, even in the absence of known risk factors. This association indicates that hepatitis C virus is responsible, at least in part, for the portal and/or lobular hepatitis associated with alcoholic liver disease.(Arch Intern Med. 1993;153:965-969)