CLINICAL IMPACT OF DRUG-ADDICTION IN ALCOHOLICS

Careful interviewing of alcoholics who wish to undergo alcohol withdra wal programmes reveals that some are Fast intravenous drug abusers. As these two potentially hepatotoxic types of substance abuse could caus e liver disease or influence its clinical course, we studied biologica l, histological and virological features in 26 alcoholics with a past history of intravenous (i.v.) drug abuse, compared with paired control s (alcoholics without i.v. drug abuse). There wire no differences with regard to routine liver test results. In contrast, the former drug ab users had a significantly higher prevalence of serum markers of hepati tis C (76.9%) and hepatitis B viruses (76.9%) than the other patients (16.7 and 12.5%, respectively). Eight patients, all of whom were HBs A g negative, were positive for serum HBV-DNA: three were former drug ab users and five were not, giving an overall prevalence of HBV markers i n the two groups of 80.8 and 25% respectively. Two former drug abusers had anti-HIV antibodies and one had anti-hepatitis delta virus antibo dies. Ten of the 17 former drug abusers who underwent liver biopsy had histological signs of viral infection. These data underline the need for careful interviews of alcoholic patients, together with serologica l tests for viral infections and histological analysis of the liver. a s some will have liver-damaging viral diseases and may be candidates f ar anti-viral (i.e. interferon) treatment.