Xu Hong-Qin, Wang Chun-Guang, Zhou Qiang, Gao Yan-Hang
Department of Hepatology, The First Hospital of Jilin University, Jilin University, Changchun 130021, Jilin Province, China.
Department of Surgery, The Second Hospital of Jilin University, Jilin University, Changchun 130041, Jilin Province, China.
World J Clin Cases. 2021 Nov 26;9(33):10052-10063. doi: 10.12998/wjcc.v9.i33.10052.
The liver is the main target organ for hepatitis viruses and the vital organ for alcohol metabolism. These two factors of viral hepatitis and alcohol abuse in combination can exert dual harmful actions, leading to enhanced damage to the liver. Epidemiological studies have revealed a higher prevalence of hepatitis C virus (HCV) infection among alcoholics than the general population. The interaction of alcohol with viral hepatitis [ hepatitis B virus (HBV), HCV] and the underlying mechanisms are not fully understood. The effects of alcohol on viral hepatitis include promoted viral replication, weakened immune response, and increased oxidative stress. Clinically, alcohol abuse is correlated with an increased risk of developing end-stage liver cirrhosis and hepatocellular carcinoma in patients with chronic hepatitis B and C, suggesting that the combination of alcohol and HBV/HCV lead to more severe liver damage. The influence of mild to moderate alcohol drinking on the HBV-induced liver fibrosis, cirrhosis, and hepatocellular carcinoma among patients infected with HBV remains unclear. Unlike HBV infected patients, no safe level of alcohol intake has been established for patients with HCV. Even light to moderate alcohol use can exert a synergistic effect with viral hepatitis, leading to the rapid progression of liver disease. Furthermore, interferon-based therapy is less effective in alcohol drinkers than in control patients, even after abstinence from alcohol for a period of time. Therefore, abstaining from alcohol is highly recommended to protect the liver, especially in individuals with HBV/HCV infection, to improve the clinical efficacy of antiviral treatment and prevent the rapid progression of chronic viral hepatitis.
肝脏是肝炎病毒的主要靶器官，也是酒精代谢的重要器官。病毒性肝炎和酒精滥用这两个因素共同作用会产生双重有害影响，导致肝脏损伤加剧。流行病学研究表明，酗酒者中丙型肝炎病毒（HCV）感染的患病率高于普通人群。酒精与病毒性肝炎（乙型肝炎病毒（HBV）、HCV）的相互作用及其潜在机制尚未完全明确。酒精对病毒性肝炎的影响包括促进病毒复制、削弱免疫反应以及增加氧化应激。临床上，酗酒与慢性乙型和丙型肝炎患者发生终末期肝硬化和肝细胞癌的风险增加相关，这表明酒精与HBV/HCV共同作用会导致更严重的肝脏损伤。轻度至中度饮酒对HBV感染患者的HBV诱导的肝纤维化、肝硬化和肝细胞癌的影响仍不明确。与HBV感染患者不同，尚未确定HCV患者的安全饮酒量。即使是轻度至中度饮酒也会与病毒性肝炎产生协同作用，导致肝病快速进展。此外，基于干扰素的治疗在饮酒者中比在对照患者中效果更差，即使在戒酒一段时间后也是如此。因此，强烈建议戒酒以保护肝脏，尤其是对于HBV/HCV感染的个体，以提高抗病毒治疗的临床疗效并防止慢性病毒性肝炎的快速进展。
