Influence of HCV infection and its subtypes on clinical course of alcoholic liver disease

Since the assay of HCV antibody has been developed, it became clear that HCV is involved not only in patients with non-A non-B hepatitis but also in some alcoholic patients. The aim of this study is to examine the prevalence of HCV in chronic alcoholics and to elucidate the influence of HCV and its subtypes on pathogenesis and clinical feature of alcoholic liver disease. To that effect, sera from 100 alcoholics were tested for antibody against C100 of HCV by ELISA and for HCV RNA by reverse transcriptation and the PCR method. The incidence of HCV Ab/RNA was 0%/17% in patients with non specific reactive hepatitis, 0%/0% in fatty liver, 17%/17% in alcoholic hepatitis, 50%/73% in chronic hepatitis, 15%/18% in liver fibrosis and 19%/31% in liver cirrhosis. HCV Ab and RNA were positive in 21% and 31% of alcoholics, respectively. Subtypes of HCV were identified by dot blot hybridization method. Type K1, K2a and K2b were detected in 68%, 25% and 7% of 28 patients with positive HCV RNA, respectively. Type PT was not detected. In addition, serum transaminase activities were evaluated after 4 weeks abstinence. The incidence of normalization of the enzyme activity was lower in patients with positive HCV RNA than that with negative HCV RNA. Furthermore, when it was estimated in relation to HCV subtypes, the incidence of normalization in patients with type K1 was lower than that with type K2. In conclusion, the prevalence of HCV infection in alcoholic patients was much greater than general population. High incidence of HCV infection was observed in advanced alcoholic liver diseases, suggesting that HCV infection might play a role, at least partly, in the pathogenesis of liver injury of chronic alcoholics. The clinical features and course of alcoholics might be altered by HCV infection, especially depending on the subtype.