DETECTION OF HEPATITIS-C VIRUS-ANTIBODIES AND HEPATITIS-C VIRUS-RNA IN PATIENTS WITH ALCOHOLIC LIVER-DISEASE

The prevalence of hepatitis C virus (HCV) antibody was determined in 1 30 patients with alcoholic liver disease using a second-generation ant i-HCV enzyme immunoassay (ELISA 2) and confirmed by a sensitive polyme rase chain reaction procedure measuring HCV RNA, Hepatic disease was e valuated by clinical and biochemical studies and, whenever possible, b y liver biopsy. Seventy-one patients were diagnosed as having cirrhosi s. and 59 alcoholic hepatitis (n = 33) or fatty liver (n = 26). The pr evalence of anti-HCV in the total group was 9.2% and did not differ si gnificantly in the cirrhotics (11.3%) as compared with the non-cirrhot ics (6.8%). HCV RNA was detected in six out of eight cirrhotics and th ree out of four non-cirrhotics who were ELISA 2 positive. A positive t est for antibodies to hepatitis core antigen (anti-HBc) was more frequ ent in anti-HCV-positive patients (75%) than in the anti-HCV-negative group (14%, P < 0.001). Anti-HBc was also found more frequently in the cirrhotics(25.4%) than in the alcoholics without cirrhosis (11.9%). H owever, the prevalence of hepatitis B surface antigen was equally low in both groups (cirrhotics 1.4%, non-cirrhotics 1.7%). No correlation was observed between the prevalence of anti-HCV antibodies and the sev erity of liver dysfunction. These results indicate that HCV, and espec ially HCV-viraemia, is less frequent in alcoholics in southern Germany than suspected in previous studies, and that the prevalence of HCV ma rkers in alcoholics has been overestimated by ELISA 1 used alone.