Clinical significance of hepatitis C virus infection to alcoholics with cirrhosis in Korea

Background/Methods: To investigate the prevalence and clinical significance of hepatitis C virus (HCV) infection and its relationship with the develop ment of hepatocellular carcinoma (HCC), 162 consecutive alcoholic patients with cirrhosis were studied. Alcohol intake and parenteral risk factors wer e investigated by interview using a questionnaire. All patients had consume d at least 80 g alcohol/day for at least the past 5 years. Sera were tested for anti-HCV using a third-generation enzyme immunoassay (EIA), hepatitis B s antigen (HBsAg), anti-HBs, anti-HBc and anti-HIV. Serum HCV-RNA was det ected by a one-tube reverse transcription-polymerase chain reaction (RT-PCR ) method. Patients were classified into three groups accroding to the prese nce or absence of viral markers: (i) cases without anti-HCV or HBsAg (group A); (ii) cases with HBsAg only (group B); and (iii) cases with anti-HCV on ly (group C). Demographic and clinical findings were compared among the thr ee groups. Results: Anti-HCV was present in 17 cases (10.5%) and HBsAg was present in 47 cases (29%). No patient had both and-HCV and HBsAg. Group C subjects wer e the oldest, but the duration of drinking in this group was similar to tha t of group A. There was no significant difference in the daily alcohol inta ke among the three groups. Previous surgical operations and tattooing were more frequent in group C. Only one patient in group C was an intravenous dr ug user. The combined rate of HCC was significantly higher in groups B and C than in groups A (34, 23.5 and 6.1%, respectively). Laboratory data showe d a higher platelet count, higher albumin level, lower bilirubin level and lower aspartate aminotransferase/alanine aminotransferase ratio in group C patients than in the other two groups. Hepatitis C virus RNA was detected i n 14 of 85 cases tested (16.5%), in 11 of 12 cases (91.7%) with anti-HCV an d in three of 73 cases (4.1%) without anti-HCV. Conclusions: Hepatitis C virus infection is frequent in alcoholic patients with cirrhosis in Korea. Hepatitis C virus, as well as hepatitis B virus, i nfection may have a synergistic effect on the development of HCC in alcohol ic patients. (C) 2000 Blackwell Science Asia Pty Ltd.