Antibodies to hepatitis B virus and hepatitis C virus in alcoholic hepatitis and cirrhosis: Their prevalence and clinical relevance

Abstract

Patients with overt alcoholic liver disease who had participated in a multicenter therapeutic trial and subgroups of controls (i.e., alcoholic patients without liver disease and patients with neither alcoholism nor liver disease) were tested for hepatitis B virus and hepatitis C virus antibodies to determine the prevalence of these antibodies and any clinical association in the progression and outcome of alcoholic liver disease. Antibodies to hepatitis B (anti-HBs and/or anti-HBc) were found in 29.2% of patients with alcoholic liver disease, in 26.1% of hospitalized alcoholic patients without liver disease and in 24.2% of hospitalized nonalcoholic patients without liver disease; frequencies were not significantly different from one another. HBsAg was not evaluated because HBsAg+ patients had been excluded from the original trial. The presence of these antibody markers correlated with ethnic origin of and immunoglobulin levels in the patients. In contrast, antibody to hepatitis C, as detected by enzyme immunoassay, was positive in 27.1%, 4.8% and 3.0% of the three groups, respectively, the first differing significantly from the other two. Antibody to hepatitis C virus positivity correlated significantly with clinical severity of the disease and with the presence of histological features that imply chronic viral infection (periportal inflammation, cirrhosis), despite the fact that the supplementary assay for antibody to hepatitis C virus, using recombinant immunoblot assay, reduced the positive rate by 79%. Although the presence of hepatitis B antibodies did not correlate with patient survival, some categories of patients with antibody to hepatitis C virus did; the survival of those with antibody to hepatitis C virus and recombinant immunoblot assay reactivity was 67%; for those with antibody to hepatitis C virus positivity but recombinant immunoblot assay negativity the survival was 29% (p < 0.01). The reason for the poor prognosis for those with antibody to hepatitis C virus positivity and recombinant immunoblot assay negativity is not clear, although some theories are offered. (Hepatology 1991;14:581-589.)

Prevalence of hepatitis B and C viruses infection in chronic alcoholics with or without liver disease in Ioannina, Greece: Low incidence of HCV infection

“…In contrast to others [9][10][11][12] we found a significantly increased prevalence of HBV infection markers among alcoholic patients, either with or without LD, compared to non-alcoholic hospitalized patients without LD. Although the alcoholic patients had a significantly increased frequency of transfusions, compared to non-alcoholic patients, the latter was not associated with more frequent detection of HBV infection markers.…”

“…However, others have not confirmed the above findings, either by measurement of serum markers, or by molecular biological studies [7,8], whereas recently, Mendenhall et al [9] showed that the frequency of antibodies to HBV, although increased, was not significantly different among alcoholic patients with LD, hospitalized alcoholic patients without LD and hospitalized non-alcoholic patients without LD. On the other hand, there are many reports where the frequency of antibodies to hepatitis C virus (anti-HCV) among alcoholic patients with LD, ranges from 27 to 42.6% increasing to 77% in patients with alcoholic cirrhosis and HCC [9][10][11][12].…”

“…On the other hand, there are many reports where the frequency of antibodies to hepatitis C virus (anti-HCV) among alcoholic patients with LD, ranges from 27 to 42.6% increasing to 77% in patients with alcoholic cirrhosis and HCC [9][10][11][12].…”

Southern Europe as an example of interaction between various environmental factors: a systematic review of the epidemiologic evidence

“…Other cross-sectional and cohort studies carried out among patients with chronic HCV infection found that alcohol intake favoured the development of cirrhosis and HCC (RoudotThoraval et al, 1997;Ikeda et al, 1998;Aizawa et al, 2000;Harris et al, 2001), and caused the development of HCC at a lower age among alcohol drinkers than non-drinkers (Yotsuyanagi et al, 2004). Reciprocally, studies among alcoholics showed a higher severity of liver disease and a higher risk of HCC in the presence of HCV infection (Mendenhall et al, 1991), and a higher HCC incidence among patients with alcoholic liver cirrhosis with HBsAg or Anti-HCV than those without hepatitis virus infection (Yamanaka et al, 2001).…”

Comorbidities of alcoholic liver disease that affect outcome of orthotopic liver transplantation

“…In particular, a substantial proportion of patients in the United States have ESLD caused by both alcohol and chronic HCV infection. [26][27][28][29] Antibody to the HCV (anti-HCV) is found in 20% to 30% (range, 18%-51%) of patients with ALD, and the majority of these patients have viremia with detectable serum HCV RNA. 26 Most patients with ALD and HCV infection have a parenteral risk factor of intravenous drug use or transfusions.…”