The influence of hepatitis C virus and its subtypes on the clinical course of liver disease in alcoholics was assessed. Hepatitis C virus infection was confirmed by a reverse transcription and polymerase chain reaction method for the hepatitis C virus NS-5 region in the sera of the alcoholics with various stages of histologically proven liver disease. The frequency of hepatitis C virus was significantly higher in alcoholics with chronic hepatitis (73%) than in those with liver fibrosis (18%), alcoholic hepatitis (17%), and fatty liver (0%). Hepatitis C virus subtypes, namely K1 and K2, were determined by dotblot hybridization analysis of the polymerase chain reaction products with specific probes, and their frequencies were 68% and 32%, respectively. The proportion of patients whose serum transaminase levels returned to normal following 4 weeks of abstinence in hospital was significantly lower in alcoholics with hepatitis C virus viremia (glutamic oxaloacetic transminase: 53.8%; glutamic pyruvic transminase: 42.3%) than in those without viremia (glutamic oxaloacetic transminase: 86.2%, p<0.01; glutamic pyruvic transminase: 89.7%, p<0.01). When alcoholics with the K1 and K2 subtypes of hepatitis C virus were compared, normalization of transminase levels was less frequent in alcoholics with K1 (glutamic oxaloacetic transminase: 42.8%; glutamic pyruvic transminase: 28.6%) than in those with K2 (glutamic oxaloacetic transminase: 88.9%, p<0.05; glutamic pyruvic transmkinase: 77.8%, p<0.05). These data indicate that hepatitis C virus infection is associated with a reduced rate of recovery of serum transminase levels following abstinence in subjects with alcoholic liver disease, more so in the K1 subtype than in the K2 subtype.
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