title: Impact of moderate alcohol consumption on histological activity and fibrosis in patients with chronic hepatitis C, and specific influence of steatosis: a prospective study.
abstract: OBJECTIVE
  To evaluate the effects of minimal to moderate alcohol consumption on the severity of histological lesions in patients with chronic hepatitis C.
  
  
  METHODS
  Daily alcohol intake (none, 1-20, 21-30, 31-50 g/day) and histological activity and fibrosis were recorded in 260 patients with chronic hepatitis C.
  
  
  RESULTS
  The proportion of patients with moderate (A2) or marked (A3) activity increased gradually from 53.8% in abstinent patients to 86.5% for an intake between 31 and 50 g/day (P = 0.003). In multivariate analysis, age > 40 years, alcohol intake between 31 and 50 g/day and moderate or severe steatosis were independently related to histological activity. The proportion of patients with moderate (F2) or marked (F3) fibrosis or cirrhosis (F4) gradually increased from 29.0% in abstinent patients to 67.6% for an intake between 31 and 50 g/day (P < 0.001). Multivariate analysis also showed that alcohol intake between 31 and 50 g/day, moderate or severe steatosis and histological activity were independently related to fibrosis. The deleterious effect of alcohol intake on histological lesions differed according to gender.
  
  
  CONCLUSIONS
  This study demonstrates that both activity and fibrosis gradually increase according to the amount of alcohol ingested, and that even moderate alcohol consumption, as low as 31-50 g/day in men and 21-50 g/day in women, may aggravate histological lesions in patients with chronic hepatitis C.
authors.affiliation: Department of Hepatology and Gastroenterology, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Université Paris XII, Créteil, France. christophe.hezode@hmn.ap-hop-paris.fr
authors.forename: C
authors.initials: C
authors.lastname: Hézode
authors.forename: I
authors.initials: I
authors.lastname: Lonjon
authors.forename: F
authors.initials: F
authors.lastname: Roudot-Thoraval
authors.forename: J-M
authors.initials: JM
authors.lastname: Pawlotsky
authors.forename: E-S
authors.initials: ES
authors.lastname: Zafrani
authors.forename: D
authors.initials: D
authors.lastname: Dhumeaux
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects* / Q000473:pathology; D018450:Disease Progression; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000473:pathology; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000209:etiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors