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HBV infection in chronic alcoholics. A survey on 287 cases
C Galli1, B Suligoi, G Spuntarelli
1Istituto Malattie Infettive, Università degli Studi di Roma La Sapienza.
Insights
Chronic alcoholics show high hepatitis B virus (HBV) infection rates (55.66%). Vaccination is recommended for this high-risk group due to potential long-term liver disease and cancer risks.
Area of Science:
- Hepatology
- Virology
- Public Health
Background:
- Chronic alcoholism is a major cause of liver disease.
- Hepatitis B virus (HBV) infection is a significant global health concern.
- The interplay between alcoholism and HBV in liver disease progression requires further investigation.
Purpose of the Study:
- To determine the prevalence of HBV infection markers in chronic alcoholics.
- To compare HBV prevalence in alcoholics with control groups.
- To assess the association between HBV infection and liver cirrhosis in alcoholics.
Main Methods:
- Serological testing for hepatitis B surface antigen (HBsAg) and other HBV markers.
- Comparison of HBV marker prevalence between cirrhotic and non-cirrhotic alcoholics.
- Statistical analysis comparing HBV positivity rates in alcoholics versus healthcare staff and the general population.
Main Results:
- Overall HBV prevalence was 55.66% among chronic alcoholics.
- HBV positivity was significantly higher in alcoholics (p < 0.01) compared to control groups.
- No significant difference in HBV marker prevalence was observed between cirrhotic and non-cirrhotic alcoholics.
Conclusions:
- Chronic alcoholics represent a high-risk group for HBV infection.
- While HBV may not directly cause cirrhosis in alcoholics, persistent infection poses risks for chronic liver disease and hepatocellular carcinoma.
- Hepatitis B vaccination is advisable for chronic alcoholics.
Abstract:
Out of 287 chronic alcoholics, 21 of whom (7.32%) resulted HBsAg positive, 106 were tested for other serum HBV markers. An overall HBV prevalence of 55.66% was found. Cirrhotic patients were slightly older than non-cirrhotics (median age: 51 vs. 47), but the prevalence of both HBsAg and other HBV markers did not differ significantly between the two groups, neither among age classes. A relevant number of subjects (18.87%) had anti-HBc alone (or associated with anti-HBe) as the unique marker of HBV infection; this leads to some uncertainties in the evaluation of active viral disease. HBV positivity rate resulted significantly higher (p less than 0.01) in alcoholics than in two control groups, composed by health-care staff and open population (respectively 34% and 32.81% of positivity). Even if hepatitis B virus did not seem to affect directly the progress to liver cirrhosis in chronic alcoholics, a large number of patients seemed unable to clear the virus, whose importance in the development of chronic liver disease and hepatocellular carcinoma is well established. For these reasons, it seems advisable to include chronic alcoholics in high-risk groups that should be vaccinated against hepatitis B.