Risks of a range of alcohol intake on hepatitis C-related fibrosis.
Heavy alcohol use contributes to liver disease in the setting of chronic hepatitis C virus (HCV) infection. Whether this is true for light or moderate alcohol use has not been demonstrated. Light alcohol use has survival benefits at a population level and is practiced by most patients with chronic HCV infection. In this study, 800 patients with HCV undergoing liver biopsy at three sites had detailed alcohol histories recorded and the relationship between alcohol and hepatic fibrosis was assessed. On univariate analysis, heavy alcohol use (>50 g/day) was associated with an increase in mean fibrosis (P =.01). Such an association could not be demonstrated for light and moderate alcohol use. For each category of alcohol intake (none, light, moderate, and heavy), a spectrum of fibrosis was observed. On multivariate analysis, age, serum alanine aminotransferase (ALT), and histological inflammation were the independent predictors of fibrosis (P = <.0001,.0003, <.0001, respectively). In conclusion, heavy alcohol use exerts a greater effect on fibrosis than light or moderate use. There is a range of fibrosis at each level of alcohol use. Age, serum ALT, and inflammation are independently associated with fibrosis in multivariate analysis, highlighting the fact that variables other than alcohol intake predominate in the production of hepatic fibrosis.
Department of Gastroenterology, University of California at San Francisco, 4150 Clement Street #111B, San Francisco, CA 94121, USA. Alexander.Monto@med.va.gov
Alexander
A
Monto
Keyur
K
Patel
Alan
A
Bostrom
Stephen
S
Pianko
Paul
P
Pockros
John G
JG
McHutchison
Teresa L
TL
Wright
D000375:Aging; D000410:Alanine Transaminase / Q000097:blood; D000428:Alcohol Drinking / Q000009:adverse effects*; D001706:Biopsy; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D006526:Hepatitis C / Q000150:complications* / Q000473:pathology; D006801:Humans; D008103:Liver Cirrhosis / Q000473:pathology* / Q000821:virology*; D015999:Multivariate Analysis; D018570:Risk Assessment
D000410:Alanine Transaminase