Prevalence of hepatitis B virus infection in out-patient alcoholics

Prevalence of hepatitis B and C viruses infection in chronic alcoholics with or without liver disease in Ioannina, Greece: low incidence of HCV infection

Intravenous heroin abusers comprise a high risk group for hepatitis B and C viruses (HBV and HCV) infection. Chronic alcoholics with liver disease (LD) also comprise a high risk group for HBV infection whereas the frequency of antibodies to HCV (anti-HCV) ranges from 27-42.6%. In this study, HBV and HCV infection markers were determined in alcoholic patients with (83 patients) or without LD (68 patients) in order to assess the prevalence of these markers (HBsAg, HBsAb, HBcAb and anti-HCV). The reason for the study was a lack of established data in this group of patients in Greece. The disease control groups consisted of 70 non-alcoholic hospitalized patients and 60 heroin addicts, whereas 1342 healthy blood donors were also investigated. Our results showed significantly increased prevalence of HBV infection markers in chronic alcoholic patients compared to healthy controls and non-alcoholic hospitalized patients. The findings were independent of the presence or absence of LD. In contrast to heroin addicts, where anti-HCV antibodies were observed in 90%, there was no difference in the prevalence of anti-HCV antibodies in chronic alcoholics (with or without LD), nonalcoholic hospitalized patients or healthy controls. In conclusion, we found that in this area of north-western Greece, chronic alcoholics, independent of the presence of LD, comprise a high risk group for HBV infection but very rarely have HCV infection. The latter finding may reflect technical or socio-economic differences regarding the lifestyle of our patients, and our population in general.

[The hepatitis B virus in alcoholic liver disease: its clinical and biochemical assessment]

The aim of our work was to study the prevalence of HBV markers in Alcoholic Liver Disease (ALD) by evaluating clinical and biochemical parameters that could further characterize the association. A prospective and sequential study of 107 patients with ALD was performed, including 83 cases of cirrhosis and 24 cases of alcoholic hepatitis. Daily ingestion of pure ethanol was of at least 70 gm for seven years or more and always associated with hepatocellular disfunction. According to the serological profile for HBV markers the patients were allocated to one of four groups: group I infected (positivity of HBsAg and anti-HBc); group II immunized (positivity of anti-HBs and anti-HBc); group III without HBV markers (negativity of HBsAg, anti-HBc and anti-HBs); group IV isolated anti-HBc. The prevalence of HBsAg positivity in ALD was high: 15.89% whereas immunity was low: 26.17% suggesting a great exposure to the virus and a deficient immunological response. No significant statistical differences were found among the three groups when clinical and biochemical parameters were individually considered. Nevertheless, when a Child/Campbell classification was applied, patients with ALD associated with HBV (group I) showed a significant difference, presenting a predominance of child C, with a bad prognosis.

Prevalence of markers of hepatitis viruses in out-patient alcoholics

The prevalence of HCV, HBV and HAV markers was investigated in unselected patients attending an outpatient alcoholic clinic. Anti-HCV were detected in 35 (24%) of 144 patients studied, and at least one marker of HBV infection was present in 72 (50%). These results are significantly higher than in a matched control population. The presence of anti-HCV was related to previous blood transfusions and familial history of alcoholism. We conclude that alcoholics should be considered a high risk group for both HCV and HBV infection.

Professional and consumer concerns about the environment, lifestyle, and cancer

Although it cannot be said that "everything causes cancer," our environment will never be carcinogen-free. As a result, there are many substances we come in contact with daily that could be potentially harmful to our health. Even with the growing knowledge of the mechanisms of carcinogenesis, it is difficult to single out the exact cancer-causing or -promoting effects of single substances. The confusion that exists about the environment, lifestyle, and cancer can be overwhelming for everyone. Garfinkel offered the following suggestions for health care providers to use in putting this issue into better perspective for consumers: (1) no single study of cancer risk factors should be used as a basis for writing or changing public health policy; (2) animal studies should be supportive of findings in epidemiological studies; (3) any environmental factor-cancer effect relationship should be demonstrated biologically; (4) regulatory agencies such as the EPA tend to be conservative in their interpretation of study results, and may suggest caution even when the risk of developing cancer is low; (5) regulatory agencies have been known to extrapolate future effects of carcinogen exposure from current incomplete or limited information about the carcinogen in question. With the knowledge that we do have, we must strive to take personal control over life-style factors that may cause cancer.

Antibodies to hepatitis B virus and hepatitis C virus in alcoholic hepatitis and cirrhosis: their prevalence and clinical relevance. The VA Cooperative Study Group (No. 119)

Patients with overt alcoholic liver disease who had participated in a multicenter therapeutic trial and subgroups of controls (i.e., alcoholic patients without liver disease and patients with neither alcoholism nor liver disease) were tested for hepatitis B virus and hepatitis C virus antibodies to determine the prevalence of these antibodies to determine the prevalence of these antibodies and any clinical association in the progression and outcome of alcoholic liver disease. Antibodies to hepatitis B (anti-HBs and/or anti-HBc) were found in 29.2% of patients with alcoholic liver disease, in 26.1% of hospitalized alcoholic patients without liver disease and in 24.2% of hospitalized nonalcoholic patients without liver disease; frequencies were not significantly different from one another. HBsAg was not evaluated because HBsAg+ patients had been excluded from the original trial. The presence of these antibody markers correlated with ethnic origin of and immunoglobulin levels in the patients. In contrast, antibody to hepatitis C, as detected by enzyme immunoassay, was positive in 27.1%, 4.8% and 3.0% of the three groups, respectively, the first differing significantly from the other two. Antibody to hepatitis C virus positivity correlated significantly with clinical severity of the disease and with the presence of histological features that imply chronic viral infection (periportal inflammation, cirrhosis), despite the fact that the supplementary assay for antibody to hepatitis C virus, using recombinant immunoblot assay, reduced the positive rate by 79%.(ABSTRACT TRUNCATED AT 250 WORDS)

Hepatic lesions in alcoholic HBV carriers

Liver biopsies were taken from 54 alcoholic HBV carriers with liver dysfunction to assess whether HBV infection or habitual drinking was the main cause of their illness. In 28 cases, ultrastructural studies were done. Results showed that 50% of the cases predominantly displayed virus-related histological changes, whereas 13% of them mainly had alcohol-related ones. Both pathological changes were evenly distributed in four cases. The remaining 15 cases showed nonspecific or other histological changes. Electron microscopy revealed that HBV core and Dane particles were seen with Mallory bodies in the same hepatocytes. Thus, we postulate that HBV-related changes are more often encountered than alcoholic ones in alcoholic HBV carriers and that HBV replication can occur even in hepatocytes bearing Mallory bodies.

Hepatitis B virus antigen and antibodies in alcoholics. Etiological role of HBV in liver diseases of alcoholic patients

A study was carried out to clarify the pathogenetic role of HBV in alcoholic patients with liver diseases. The incidence of serological markers of HBV infection was investigated in these patients and the histological characteristics were compared among the alcoholic patients with and without HBV markers. A high percentage of patients were positive for either HBsAg, anti-HBs or anti-HBc. In six of eight patients with positive HBsAg, liver histology showed viral features, but in 23 of 39 patients with positive anti-HBs and/or low titre anti-HBc and in 12 of 18 patients with negative HBV markers liver histology showed alcoholic features. From these results it is concluded that HBV presumably plays a major role in the pathogenesis of liver disease in alcoholic patients with persistent HBV infection but not in patients with positive antibodies.