ALCOHOLISM IS ASSOCIATED WITH HEPATITIS-C BUT NOT HEPATITIS-B IN AN URBAN-POPULATION

Objectives: Previous studies have suggested an association of viral he patitis with alcoholism, although the role of confounding risk factors (e.g., i.v. drug use) has not been adequately excluded. We therefore compared the seroprevalences of hepatitis B and C in alcoholic patient s to that of a nonalcoholic control group. Methods: Hepatitis B surfac e antigen, hepatitis B core antibody, hepatitis B surface antibody, an d hepatitis C virus antibody testing (second generation ELISA and a co nfirmatory recombinant immunoblot assay) was performed in 150 consecut ive alcoholics admitted for detoxification and in 166 randomly selecte d patients attending a general medical clinic who were screened for al coholism. Results: Hepatitis B and C seropositivities in actively drin king alcoholics were 49.3% and 35.3%, respectively, and were significa ntly associated with a history of i.v. drug abuse. Out of 166 general medicine clinic patients, 93 were classified as nonalcoholic (by both self-report and collateral verification), 46 patients had a history of alcoholism, and 27 were indeterminate. In the subgroup of patients wi thout known viral hepatitis risk factors, there was no significant dif ference in hepatitis B seropositivity among nonalcoholic general medic ine clinic patients, alcoholic general medicine clinic patients, and a lcoholic patients admitted for detoxification (22.1%, 30.3%, and 27.6% , respectively). In contrast, anti-HCV recombinant immunoblot assay se ropositivity in alcoholic patients admitted for detoxification without risk factors was significantly greater than in nonalcoholic general m edicine patients without risk factors (10 vs 0%, p < 0.01). Stepwise l ogistic regression analysis revealed that alcoholism requiring detoxif ication was a significant risk factor for hepatitis C but not for hepa titis B seropositivity. Conclusions: The increased seroprevalence of h epatitis C in actively drinking alcoholic patients without known risk factors suggests that alcoholism, in some way, is a predisposing facto r for HCV infection.