title: Chronic hepatitis C in alcoholic patients: prevalence, genotypes, and correlation to liver disease.
abstract: BACKGROUND
  Only one-fifth of chronic alcoholic patients develop chronic liver disease in spite of continuous alcohol abuse. Hepatitis C has been proposed to be one of several suggested factors contributing to the development of liver disease.
  
  
  METHODS
  In 201 consecutive chronic alcoholic patients admitted to the hospital for detoxification, antibodies to hepatitis C virus (HCV) were determined, using second-generation enzyme-linked immunosorbent assay (ELISA) and recombinant immunoblot assay (RIBA) tests. Sera from patients with antibodies were tested with polymerase chain reaction (PCR) to detect HCV RNA and subsequently genotyped.
  
  
  RESULTS
  Twenty-nine patients (14%) were positive in the ELISA and RIBA tests. HCV RNA was detected in 23 of the 29 (79%); 21 could be genotyped. Previous intravenous drug abuse was present in 18 of 29 (58%) in the positive group versus 3 of 172 (2%) in the negative group (p < 0.001), whereas the prevalence of previous blood transfusions did not differ between the groups. In one-third of the positive cases no obvious route of transmission was found. On the basis of clinical and biochemical variables and, if available, histology, altogether 6 of 29 (21%) HCV-positive patients were classified as having severe liver disease as compared with 12 of 172 (7%) HCV-negative patients (p < 0.05). HCV-positive patients with liver disease were younger than HCV-negative patients with liver disease (p < 0.05).
  
  
  CONCLUSIONS
  Hepatitis C virus infection is common among chronic alcoholic patients in Stockholm, especially among patients with a history of intravenous drug abuse. To confirm ongoing infection, detection of HCV RNA is necessary. This infection seems to be a factor contributing to the development of liver disease in alcoholic patients.
authors.affiliation: Dept. of Internal Medicine, Karolinska Hospital, Stockholm, Sweden.
authors.forename: R
authors.initials: R
authors.lastname: Befrits
authors.forename: M
authors.initials: M
authors.lastname: Hedman
authors.forename: L
authors.initials: L
authors.lastname: Blomquist
authors.forename: T
authors.initials: T
authors.lastname: Allander
authors.forename: L
authors.initials: L
authors.lastname: Grillner
authors.forename: N
authors.initials: N
authors.lastname: Kinnman
authors.forename: C
authors.initials: C
authors.lastname: Rubio
authors.forename: R
authors.initials: R
authors.lastname: Hultcrantz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000437:Alcoholism / Q000150:complications*; D002908:Chronic Disease; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology; D006526:Hepatitis C / Q000150:complications* / Q000453:epidemiology; D018937:Hepatitis C Antibodies / Q000032:analysis; D006801:Humans; D015151:Immunoblotting; D008108:Liver Diseases, Alcoholic / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D015995:Prevalence; D015819:Substance Abuse, Intravenous / Q000150:complications
chemical_list: D018937:Hepatitis C Antibodies