Synergism Exists Between HCV and Alcoholism
June 24, 1996.
Risk Factors (Liver Disease); Synergism Exists Between HCV and
Alcoholism.Hepatitis Weekly via Individual Inc:
Hepatitis C virus exacerbates the liver damage caused by
alcohol-related disease, according to a report from Taiwan. "Our
data suggest that the presence of hepatitis C virus infection
exerts a multiplicative synergistic effect for alcohol-related
impaired liver functionand that chronic hepatitis C virus hepatitis
may increase the liver damage in alcoholic cases with liver
disease," researcher Chen- Tang Shen and colleagues wrote
("Alcoholism, Hepatitis B and C Viral Infections, and Impaired
Liver Function among Taiwanese Aboriginal Groups," American Journal
of Epidemiology, May 1, 1996;143(9):936-942). Viral hepatitis and
alcoholism are prevalent in four major Taiwanese aboriginal
groups.
In this study, Chen-Tang Shen and colleagues examined the
relative importance of the acquisition of hepatitis B or C virus
infection and alcoholism to the presence of impaired liver function
in these groups.
Shen et al. conducted a semistructured clinical interview for
alcoholism and tested for seromarkers of viral hepati- tis among
993 people enrolled in an ongoing prospective study between 1990
and 1992 (Taiwan Aboriginal Study Project).
The subjects' blood specimens were tested for serum alan- ine
aminotransferase/aspartate aminotransferase levels and for the
presence of hepatitis B surface antigen and anti-hepatitis C virus
antibody. The prevalence of a combination of an alanine
aminotransferase level of more than 35 IU/liter and an aspartate
aminotransferase levels of more than 40 IU/liter, implying impaired
liver function or advanced liver disease, was 4.3 percent overall.
Univariate and multiple logistic regression analysis showed that
hepatitis C virus infection and alcoholism were the two dominant
risk factors that signalled the risk of liver damage among these
Taiwanese aborigines. In addition, these two contributing factors
were able to act synergistically to cause impaired liver
function.Shen et al. suggested that this synergism may result from
the damaging of hepatic cells by early infection with hepatitis
viruses followed by impaired wound healing response to liver
regeneration caused by long-term alcohol consumption.
"It was recently shown that habitual alcoholic drinking was able
to increase hepatitis C virus RNA levels in serum (which indicates
the proliferation of hepatitis C virus), subsequently resulting in
the progression of liver damage," Shen et al. wrote. "The extremely
high prevalence of alcoholism and relatively high rate of hepatitis
C virus infection in our aboriginal communities make it likely that
the contributions of both factors to the risks of elevated levels
of alanine aminotransferase/aspartate aminotransferase and other
liver diseases are much more important than in other
populations.
"We are conducting prospective studies to understand the subtle
interactions between excessive alcohol drinking and viral hepatitis
and the genetic and environmental factors that may contribute to
impaired liver function and liver diseases in these aboriginal
populations."
The corresponding author for this study is Andrew Cheng,
Institute of Biomedical Sciences, Academia Sinica, Taipei 11529,
Taiwan. - by Salynn Boyles, Senior Editor
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