title: Alcoholic liver disease and hepatitis C virus infection.
abstract: Alcohol consumption and hepatitis C virus (HCV) infection have a synergic hepatotoxic effect, and the coexistence of these factors increases the risk of advanced liver disease. The main mechanisms of this effect are increased viral replication and altered immune response, although genetic predisposition may also play an important role. Traditionally, HCV prevalence has been considered to be higher (up to 50%) in alcoholic patients than in the general population. However, the presence of advanced alcoholic liver disease (ALD) or intravenous drug use (IDU) may have confounded the results of previous studies, and the real prevalence of HCV infection in alcoholic patients without ALD or prior IDU has been shown to be lower. Due to the toxic combined effect of HCV and alcohol, patients with HCV infection should be screened for excessive ethanol intake. Patients starting treatment for HCV infection should be specifically advised to stop or reduce alcohol consumption because of its potential impact on treatment efficacy and adherence and may benefit from additional support during antiviral therapy. This recommendation might be extended to all currently recommended drugs for HCV treatment. Patients with alcohol dependence and HCV infection, can be treated with acamprosate, nalmefene, topiramate, and disulfiram, although baclofen is the only drug specifically tested for this purpose in patients with ALD and/or HCV infection.
authors.affiliation: Ignacio Novo-Veleiro, Lucía Alvela-Suárez, Department of Internal Medicine, University Hospital of Santiago de Compostela, 37007 Salamanca, Spain.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Novo-Veleiro
authors.affiliation: Ignacio Novo-Veleiro, Lucía Alvela-Suárez, Department of Internal Medicine, University Hospital of Santiago de Compostela, 37007 Salamanca, Spain.
authors.forename: Lucía
authors.initials: L
authors.lastname: Alvela-Suárez
authors.affiliation: Ignacio Novo-Veleiro, Lucía Alvela-Suárez, Department of Internal Medicine, University Hospital of Santiago de Compostela, 37007 Salamanca, Spain.
authors.forename: Antonio-Javier
authors.initials: AJ
authors.lastname: Chamorro
authors.affiliation: Ignacio Novo-Veleiro, Lucía Alvela-Suárez, Department of Internal Medicine, University Hospital of Santiago de Compostela, 37007 Salamanca, Spain.
authors.forename: Rogelio
authors.initials: R
authors.lastname: González-Sarmiento
authors.affiliation: Ignacio Novo-Veleiro, Lucía Alvela-Suárez, Department of Internal Medicine, University Hospital of Santiago de Compostela, 37007 Salamanca, Spain.
authors.forename: Francisco-Javier
authors.initials: FJ
authors.lastname: Laso
authors.affiliation: Ignacio Novo-Veleiro, Lucía Alvela-Suárez, Department of Internal Medicine, University Hospital of Santiago de Compostela, 37007 Salamanca, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Marcos
mesh_terms: D064829:Alcohol Abstinence; D000428:Alcohol Drinking / Q000009:adverse effects* / Q000453:epidemiology / Q000517:prevention & control; D000818:Animals; D000998:Antiviral Agents / Q000627:therapeutic use; D020022:Genetic Predisposition to Disease; D006526:Hepatitis C / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000235:genetics; D006801:Humans; D008108:Liver Diseases, Alcoholic / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics / Q000628:therapy; D015995:Prevalence; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents
keywords: Alcohol dependence; Alcohol use disorder; Alcoholic liver disease; Alcoholism; Hepatitis C virus infection; Hepatitis C virus infection treatment
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