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Chronic alcoholism in patients with chronic hepatitis C hastens
disease progression toward development of cirrhosis and
hepatocellular carcinoma. Approximately 30% of alcoholic patients
with liver disease are infected with the hepatitis C virus (HCV),
the primary risk factor being a history of injection drug use. The
histologic pattern in alcoholics is typically indistinguishable
from nonalcoholic patients similarly infected with chronic
hepatitis C. The mechanism(s) involved in alcohol-induced
enhancement of chronic hepatitis C have not entirely been
established but may involve increased viral replication, iron
overload, and immune suppression. Still to be determined is the
minimum amount of daily alcohol intake, if any, that can be
ingested without enhancing progressive liver injury. However,
chronic hepatitis C patients undergoing treatment with interferon
must abstain from any alcohol intake, because the efficacy of
interferon therapy is significantly lower in those who continue to
drink. Future research efforts are needed in order to further
delineate the epidemiology and pathogenesis of chronic hepatitis C
in the alcoholic patient.
AUTHOR: Schiff ER, Department of Medicine, University of
Miami, Florida 33136, USA.
SOURCE: Am J Med 1999 Dec 27;107(6B):95S-99S
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