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Enhancement of chronic viral hepatitic changes by alcohol intake in patients with persistent HBs-antigenemia
T Murata1, H Takanari, S Watanabe
1Department of Pathology, Mie University School of Medicine, Japan.
Insights
Heavy alcohol consumption may worsen liver inflammation in patients with persistent Hepatitis B surface antigenemia (HBsAg). This study found higher rates of chronic active hepatitis (CAH) and more severe inflammatory changes in habitual drinkers.
Area of Science:
- Hepatology
- Gastroenterology
- Virology
Background:
- Persistent Hepatitis B surface antigenemia (HBsAg) is a significant cause of chronic liver disease.
- Alcohol consumption is a common co-factor in liver disease progression.
Purpose of the Study:
- To investigate the impact of alcohol consumption on liver histology in patients with persistent HBsAg.
- To determine if alcohol intake modifies the inflammatory response in chronic Hepatitis B.
Main Methods:
- Analysis of clinical and histological data from 116 Japanese patients with persistent HBsAg.
- Patients were stratified into non-drinkers, social drinkers, and habitual drinkers (≥60g ethanol/day for ≥10 years).
- Histological examination focused on inflammatory changes, necrosis, and alcohol-related liver damage.
Main Results:
- Habitual drinkers showed a significantly higher frequency of chronic active hepatitis (CAH) compared to non-drinkers and social drinkers (P<0.05).
- Histological analysis revealed more prominent portal tract inflammation and piecemeal necrosis in habitual drinkers with CAH.
- No specific alcohol-related liver changes, apart from fatty change, were observed.
Conclusions:
- Daily intake of over 60g of ethanol may exacerbate viral-induced liver inflammation in patients with persistent HBsAg.
- Alcohol acts as a co-factor that enhances inflammatory liver damage in chronic Hepatitis B.
- Findings highlight the detrimental effect of significant alcohol consumption on HBsAg-positive chronic liver disease.
Abstract:
The clinical and histologic changes in 116 Japanese patients with persistent HBs-antigenemia and chronic liver diseases were analyzed after the patients were divided into three groups depending on the history of alcohol consumption. Group 1 consisted of 45 nondrinkers, Group 2 of 51 social drinkers, and Group 3 of 20 habitual drinkers with a daily intake of more than 60 g of ethanol for at least ten years. The frequency of chronic active hepatitis (CAH) in Group 3 was higher than in Groups 1 and 2 (P less than 0.05). The histologic comparison of patients with CAH between the three groups revealed that only the inflammatory changes at/near portal tracts, such as piecemeal necrosis and inflammatory cell infiltration in Group 3, were more prominent than those in Groups 1 and 2. The alcohol-related changes except for fatty change were not found in any specimens. These findings suggest that alcohol intake, particularly of more than 60 g of ethanol a day, may enhance the viral inflammatory changes of the liver in patients with persistent HBs-antigenemia.