An epidemiologic study of effects of alcohol in the liver in hepatitis B surface antigen carriers

A total of 932 hepatitis B surface antigen (HBsAg) carriers and 1,704 HBsAg-negative inhabitants of the Yaeyama District of Okinawa, Japan, over age 20 years were investigated in 1982-1985 in order to elucidate whether an interaction between habitual alcohol intake and hepatitis B virus infection is capable of producing liver disease. All of the subjects were tested for biochemical liver functions and asked about their habitual intake of alcohol. HBsAg carriers were tested for hepatitis B e antigen (HBeAg) and antibody to HBeAg. Subjects were ranked into three categories by alcohol consumption: nondrinkers, light drinkers (1-59 g/day), and heavy drinkers (greater than or equal to 60 g/day). The prevalence of liver abnormalities in HBsAg carriers increased with alcohol consumption. The prevalence differed significantly between nondrinkers and light drinkers in HBsAg carriers (p less than 0.001), but not in HBsAg-negative inhabitants. Prevalence also differed significantly between nondrinkers and heavy drinkers irrespective of HBsAg positivity (p less than 0.001). The highest prevalence of liver abnormalities was observed in HBeAg-positive heavy drinkers (53.8%). In conclusion, this study confirms that alcohol consumption intensifies the development of liver disease caused by hepatitis B virus. Therefore, the authors see a need to educate HBsAg carriers about the risks of consuming alcohol.