title: Mild alcohol consumption is not associated with increased fibrosis in patients with chronic hepatitis C.
abstract: BACKGROUND
  Excessive alcohol consumption is associated with an increased risk for fibrosis progression and cirrhosis in patients with chronic hepatitis C virus (HCV) infection. However, the impact of mild-moderate alcohol use on the severity of liver fibrosis is unclear.
  
  
  OBJECTIVE
  The objective of this retrospective study was to assess the impact of mild alcohol consumption on liver fibrosis in patients with chronic HCV.
  
  
  METHODS
  857 patients with well-characterized chronic HCV were enrolled. All underwent liver biopsy to assess hepatic fibrosis. The duration of HCV infection was determined by detailed questionnaires and personal interviews. Alcohol use history was estimated by the Skinner Alcohol Examination Questionnaire. Mild alcohol use was defined as 1 to 3 alcoholic beverages/day (<30 grams/d). Participants were divided into 4 groups based on their average lifetime daily alcohol consumption (essentially none, <1, 1 to 3 or >3 drinks/d) and into quartiles based on their presumed duration of HCV infection (<23, 23 to 31, 31 to 38, or >38 y).
  
  
  RESULTS
  Mean alcohol consumption was 2.7 drinks/d; mean duration of HCV infection was 29 years. Daily alcohol consumption was not significantly higher among participants with advanced fibrosis (bridging fibrosis or cirrhosis) when compared with those with none or portal fibrosis (3.2 vs. 2.2 drinks/d, respectively, P=NS). The degree of fibrosis increased significantly with the duration of HCV infection (P<0.0001) and was independent of mild-moderate alcohol consumption.
  
  
  CONCLUSIONS
  Mild alcohol use does not seem to adversely affect the severity of fibrosis in patients with chronic HCV.
authors.affiliation: Hepatology Section, Virginia Commonwealth University Medical Center, Richmond, VA, USA.
authors.forename: Onpan
authors.initials: O
authors.lastname: Cheung
authors.forename: Richard K
authors.initials: RK
authors.lastname: Sterling
authors.forename: Jennifer
authors.initials: J
authors.lastname: Salvatori
authors.forename: Kim
authors.initials: K
authors.lastname: Williams
authors.forename: Sarah
authors.initials: S
authors.lastname: Hubbard
authors.forename: Velimir A
authors.initials: VA
authors.lastname: Luketic
authors.forename: Todd R
authors.initials: TR
authors.lastname: Stravitz
authors.forename: Arun J
authors.initials: AJ
authors.lastname: Sanyal
authors.forename: Melissa J
authors.initials: MJ
authors.lastname: Contos
authors.forename: Scott
authors.initials: S
authors.lastname: Mills
authors.forename: Mitchell L
authors.initials: ML
authors.lastname: Shiffman
mesh_terms: D000428:Alcohol Drinking / Q000009:adverse effects* / Q000453:epidemiology; D001706:Biopsy; D018450:Disease Progression; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires