Contribution of hepatitis C virus to the progression of alcoholic liver disease

Background: We determined hepatitis C virus (HCV) antibody, HCV RNA, and ge notype in patients with alcoholic liver disease and studied the involvement of HCV in alcoholic liver disease. Additionally, we used the histological activity index (HAI) to study the influence of HCV on the severity of infla mmation. Methods: The subjects were 143 patients with alcoholic liver disease: 7 wit h fatty liver (FL), 18 with hepatic fibrosis (HF), 24 with alcoholic hepati tis (ALH), 39 with chronic hepatitis (CH), 42 with liver cirrhosis (LC), an d 13 with hepatocellular carcinoma (HCC). The HCV RNA positivity rate in ea ch type of disease was 0/7 (0%), 1/18 (6%), 2/24 (8%), 27/39 (69%), 24]42 ( 57%), and 7/13 (54%), respectively. It was high in the advanced hepatic les ions. Results: Clinically, the serum hepatic function tests after abstinence from drinking improved significantly in the HCV RNA negative patients compared with the positive patients. The proportion of genotype II in each type of d isease was 0/0, 0/1 (0%), 1/2 (50%), 18/27 (67%), 18/24 (75%), and 7/7 (100 %), respectively. It became high with the advance of pathophysiology. The H CV RNA amount stood at 71.5 +/- 0.4 [log (copies/ml)] in CH, 7.9 +/- 0.4 in LC, and 8.4 +/- 0.8 in HCC, with a statistically Significant difference be tween CH and HCC. However, we found no changes in the HCV RNA amount due to abstinence from drinking. The HAI score was high in the HCV RNA positive p atients, but several cases in the HCV RNA negative group showed severe infl ammatory changes. Therefore, judging the presence or absence of HCV RNA wit h the HAI score alone was considered difficult. Conclusions:: These results suggest that HCV, particularly genotype II, pla ys an important role in the advance of disease to LC and HCC in heavy drink ers.