As. Rosman et al., HEPATITIS-C VIRUS-ANTIBODY IN ALCOHOLIC PATIENTS - ASSOCIATION WITH THE PRESENCE OF PORTAL AND OR LOBULAR HEPATITIS/, Archives of internal medicine, 153(8), 1993, pp. 965-969
Objective: To evaluate the relationship between hepatitis C viral infe
ction and alcoholic liver disease. Design: Case-comparison study. Sett
ing: Bronx (NY) Veterans Affairs Medical Center. Participants: Forty-s
even consecutive alcoholic patients undergoing diagnostic liver biopsy
. Main Outcome Measures: Serum was obtained at the time of liver biops
y and assayed for antibodies to hepatitis C virus using enzyme-linked
immunosorbent assay, recombinant immunoblot assay, and hepatitis C vir
us neutralization methods. Results: Antibody to hepatitis C virus, as
confirmed by the recombinant immunoblot assay, was strongly associated
with the presence of portal and/or lobular inflammation (91% seroposi
tivity) but was only present in 16% of patients without this histologi
c finding (P<.001). In patients without portal or lobular hepatitis, r
ecombinant immunoblot assay seropositivity was seen in 27% of patients
with cirrhosis and 20% of patients with alcoholic hepatitis and was a
bsent in patients with steatosis and/or perivenular fibrosis. In the s
ubgroup of alcoholic patients who were without known risk factors for
hepatitis C virus infection (ie, no history of intravenous drug use or
blood transfusions), antibody to hepatitis C virus was present in 78%
of subjects with portal and/or lobular hepatitis but was absent in th
ose with other types of alcoholic liver disease. Finally, anti-hepatit
is C virus-seropositive patients had a significantly greater mean necr
oinflammatory score as compared with anti-hepatitis C virus-seronegati
ve alcoholic patients (2.1 vs 1.2; P<.001). In contrast, there was no
significant difference in the mean fibrosis score between the two grou
ps. Conclusions: The presence of portal and/or lobular inflammation is
strongly associated with antibodies to hepatitis C virus in alcoholic
patients, even in the absence of known risk factors. This association
indicates that hepatitis C virus is responsible, at least in part, fo
r the portal and/or lobular hepatitis associated with alcoholic liver
disease.