INTERACTIONS BETWEEN ALCOHOL AND HEPATITIS VIRUSES IN THE LIVER

There is a high frequency of hepatitis B virus (HBV) and hepatitis C v irus (HCV) infections among individuals with alcoholic liver disease ( ALD) and alcohol-associated hepatocellular carcinoma (HCC), suggesting that these viruses are implicated in the pathogenesis of these diseas es. Alcohol may act synergistically by promoting the development and p rogression of liver disease. The interactions of alcohol with infected hepatocytes and with antiviral immunity may result in altered pattern s of virus gene expression and replication, making diagnosis difficult in some cases of ALD and HCC. The potential association of ALD and al coholic HCC with serologically negative virus variants raises major di fficulties in the epidemiologic assessment of cause and effect, provid ing major challenges for the future.