HEPATITIS-C AND ALCOHOL

Chronic alcoholism in patients with chronic hepatitis C appears to cau se more severe and rapidly progressive liver disease leading more freq uently to cirrhosis of the liver and hepatocellular carcinoma. The pri mary risk factor for acquiring hepatitis C among alcoholics is injecti on drug use. However, the epidemiology is not well defined, and other sources of spread must be important. Alcohol intake in excess of 10 g/ d has been associated with increased serum hepatitis C viral RNA and a minotransferase levels, the mechanism of which is poorly understood. T he histological picture of hepatitis C in patients with chronic alcoho lism is typically indistinguishable from chronic hepatitis C in nonalc oholic patients. Interferon therapy is less effective among alcoholic than nonalcoholic patients, even after a period of abstinence. Patient s with chronic hepatitis C should restrict their alcohol intake to les s than 10 g/d, and if cirrhosis is present or interferon therapy is pl anned, abstinence from alcohol should be encouraged. Future research e fforts should focus on the epidemiology and pathogenesis of combined c hronic hepatitis C and alcoholism.