INCREASED SERUM HEPATITIS-C VIRUS-RNA LEVELS AMONG ALCOHOLIC PATIENTSWITH CHRONIC HEPATITIS-C

Hepatitis viruses and alcohol are major causes of liver disease. This study was aimed at investigating the effect of alcohol intake on the r eplication of hepatitis C virus and the efficacy of interferon therapy . Fifty-three patients who were histologically proved to have chronic hepatitis C were tested. Of these, 16 were diagnosed as habitual drink ers whose cumulative total consumption of alcohol was more than 100 kg or who had consumed at least 60 gm of ethanol daily for at least 5 yr . The quantities of hepatitis C virus RNA in serum were measured with a competitive assay that combined reverse transcription and polymerase chain reaction. The subjects received a 26-wk course of interferon-al pha therapy. There were no significant differences in age and ALT leve ls between habitual drinkers and nonhabitual drinkers. The titer of vi ral RNA (logarithmic transformed copy numbers per milliliter of serum) of habitual drinkers (8.5 +/- 0.5) was higher than that of nonhabitua l drinkers (7.7 +/- 0.8) (p < 0.01). Neopterin levels in serum, a mark er for the activation of cell-mediated immunity, were lower for habitu al drinkers (5.7 +/- 1.5 pmol/ml) than for nonhabitual drinkers (8.1 /- 5.0 pmol/ml) (p < 0.01). Eleven of the nonhabitual drinkers (30%) w ere long-term responders whose alanine aminotransferase levels remaine d within normal range during the 24 wk after interferon therapy, where as only one (6%) of the habitual drinkers was a long-term responder (p = 0.06). These findings suggest that alcohol intake increases hepatit is C virus RNA levels in serum-at least in part-impairment of cellular immunity, and modulates the efficacy of interferon therapy.