Rosman A S, Waraich A, Galvin K, Casiano J, Paronetto F, Lieber C S
Alcohol Research and Treatment Center, Section of Liver Disease and Nutrition, Bronx VA Medical Center, Bronx, New York, USA.
Am J Gastroenterol. 1996 Mar;91(3):498-505.
Previous studies have suggested an association of viral hepatitis with alcoholism, although the role of confounding risk factors (e.g. i.v. drug use) has not been adequately excluded. We therefore compared the seroprevalences of hepatitis B and C in alcoholic patients to that of a nonalcoholic control group.
Hepatitis B surface antigen, hepatitis B core antibody, hepatitis B surface antibody, and hepatitis C virus antibody testing (second generation ELISA and a confirmatory recombinant immunoblot assay) was performed in 150 consecutive alcoholics admitted for detoxification and in 166 randomly selected patients attending a general medical clinic who were screened for alcoholism.
Hepatitis B and C seropositivities in actively drinking alcoholics are 49.3 and 35.3%, respectively, and were significantly associated with a history of i.v. drug abuse. Out of 166 general medicine clinics patients, 93 were classified as nonalcoholic (by both self-report and collateral verification), 46 patients had a history of alcoholism , and 27 were indeterminate. In the subgroup of patients without known viral hepatitis risk factors, there was no significant difference in hepatitis B seropositivity among nonalcoholic general medicine clinic patients, alcoholic general medicine clinic patients, and alcoholic patients admitted for detoxification (22.1%, 30.3%, and 27.6%, respectively). In contrast, anti-HCV recombinant immunoblot assay seropositivity in alcohol patients admitted for detoxification without risk factors was significantly greater than in nonalcoholic general medicine patients without risk factors (10 vs 0%, p >0.01). Stepwise logistic regression analysis revealed that alcoholism requiring detoxification was a significant risk factor for hepatitis C but not for hepatitis B seropositivity.
The increased seroprevalence of hepatitis C in actively drinking alcoholic patients without known risk factors suggests that alcoholism, in some way, is a predisposing factor for HCV infection.
既往研究提示病毒性肝炎与酗酒有关，尽管混杂风险因素（如静脉注射吸毒）的作用尚未被充分排除。因此，我们比较了酗酒患者与非酗酒对照组中乙型和丙型肝炎的血清阳性率。
对150例连续入院戒酒的酗酒者以及166例随机选取的在普通内科门诊接受酗酒筛查的患者进行了乙型肝炎表面抗原、乙型肝炎核心抗体、乙型肝炎表面抗体以及丙型肝炎病毒抗体检测（第二代酶联免疫吸附测定和确证性重组免疫印迹法）。
正在饮酒的酗酒者中乙型和丙型肝炎血清阳性率分别为49.3%和35.3%，且与静脉注射吸毒史显著相关。在166例普通内科门诊患者中，93例被归类为非酗酒者（通过自我报告和旁证核实），46例有酗酒史，27例情况不明。在无已知病毒性肝炎风险因素的患者亚组中，非酗酒普通内科门诊患者、酗酒普通内科门诊患者以及入院戒酒的酗酒患者之间的乙型肝炎血清阳性率无显著差异（分别为22.1%、30.3%和27.6%）。相比之下，无风险因素的入院戒酒酗酒患者的抗丙型肝炎病毒重组免疫印迹法血清阳性率显著高于无风险因素的非酗酒普通内科患者（10%对0%，p>0.01）。逐步逻辑回归分析显示，需要戒酒的酗酒是丙型肝炎的显著风险因素，但不是乙型肝炎血清阳性的风险因素。
在无已知风险因素的正在饮酒的酗酒患者中丙型肝炎血清阳性率升高，提示酗酒在某种程度上是丙型肝炎病毒感染的易感因素。
