Hepatitis C virus antibody in alcoholic patients. Association with the presence of portal and/or lobular hepatitis.
OBJECTIVE
To evaluate the relationship between hepatitis C viral infection and alcoholic liver disease.


METHODS
Case-comparison study.


METHODS
Bronx (NY) Veterans Affairs Medical Center.


METHODS
Forty-seven consecutive alcoholic patients undergoing diagnostic liver biopsy.


METHODS
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.
Rosman
A S
AS
Alcohol Research and Treatment Center, Bronx Veterans Affairs Medical Center, NY.
Paronetto
F
F
Galvin
K
K
Williams
R J
RJ
Lieber
C S
CS
D000328:Adult; D004797:Enzyme-Linked Immunosorbent Assay; D016174:Hepacivirus / Q000276:immunology*; D006508:Hepatitis Antibodies / Q000032:analysis; D006526:Hepatitis C / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology / Q000473:pathology; D018937:Hepatitis C Antibodies; D006519:Hepatitis, Alcoholic / Q000150:complications* / Q000473:pathology; D006801:Humans; D008099:Liver / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012698:Serologic Tests
D006508:Hepatitis Antibodies; D018937:Hepatitis C Antibodies