Hepatitis C virus antibody in alcoholic patients. Association with the presence of portal and/or lobular hepatitis

• Published in: Archives of internal medicine (1960) Vol. 153; no. 8; p. 965
• Main Authors: Rosman, A S, Paronetto, F, Galvin, K, Williams, R J, Lieber, C S
• Format: Journal Article
• Language: English
• Published: United States 26.04.1993
• Subjects: Adult; Enzyme-Linked Immunosorbent Assay; Hepacivirus - immunology; Hepatitis Antibodies - analysis; Hepatitis C - diagnosis; Hepatitis C - etiology; Hepatitis C - immunology; Hepatitis C - pathology; Hepatitis C Antibodies; Hepatitis, Alcoholic - complications; Hepatitis, Alcoholic - pathology; Humans; Liver - pathology; Male; Middle Aged; Serologic Tests
• ISSN: 0003-9926
• DOI: 10.1001/archinte.1993.00410080031005

To evaluate the relationship between hepatitis C viral infection and alcoholic liver disease. Case-comparison study. Bronx (NY) Veterans Affairs Medical Center. Forty-seven consecutive alcoholic patients undergoing diagnostic liver biopsy. Serum was obtained at the time of liver biopsy and assayed for antibodies to hepatitis C virus using enzyme-linked immunosorbent assay, recombinant immunoblot assay, and hepatitis C virus neutralization methods. Antibody to hepatitis C virus, as confirmed by the recombinant immunoblot assay, was strongly associated with the presence of portal and/or lobular inflammation (91% seropositivity) but was only present in 16% of patients without this histologic finding (P < .001). In patients without portal or lobular hepatitis, recombinant immunoblot assay seropositivity was seen in 27% of patients with cirrhosis and 20% of patients with alcoholic hepatitis and was absent in patients with steatosis and/or perivenular fibrosis. In the subgroup of alcoholic patients who were without known risk factors for hepatitis C virus infection (ie, no history of intravenous drug use or blood transfusions), antibody to hepatitis C virus was present in 78% of subjects with portal and/or lobular hepatitis but was absent in those with other types of alcoholic liver disease. Finally, anti-hepatitis C virus-seropositive patients had a significantly greater mean necroinflammatory score as compared with anti-hepatitis C virus-seronegative alcoholic patients (2.1 vs 1.2; P < .001). In contrast, there was no significant difference in the mean fibrosis score between the two groups. The presence of portal and/or lobular inflammation is strongly associated with antibodies to hepatitis C virus in alcoholic patients, even in the absence of known risk factors. This association indicates that hepatitis C virus is responsible, at least in part, for the portal and/or lobular hepatitis associated with alcoholic liver disease.