The influence of hepatitis C virus and its subtypes on the
clinical course of
liver disease in alcoholics was assessed. Hepatitis C virus
infection was confirmed by a reverse transcription and polymerase chain reaction method for the hepatitis C virus
NS-5 region in the sera of alcoholics with various stages of histologically proven
liver disease. The frequency of hepatitis C virus was significantly higher in alcoholics with
chronic hepatitis (73%) than in those with
liver fibrosis (18%),
alcoholic hepatitis (17%), and
fatty liver (0%). Hepatitis C virus subtypes, namely K1 and K2, were determined by dot-blot hybridization analysis of the polymerase chain reaction products with specific probes, and their frequencies were 68% and 32%, respectively. The proportion of patients whose serum
transaminase levels returned to normal following 4 weeks of abstinence in hospital was significantly lower in alcoholics with hepatitis C virus
viremia (
glutamic oxaloacetic transaminase: 53.8%;
glutamic pyruvic transaminase: 42.3%) than in those without
viremia (
glutamic oxaloacetic transaminase: 86.2%, p < 0.01;
glutamic pyruvic transaminase: 89.7%, p < 0.01). When alcoholics with the K1 and K2 subtypes of hepatitis C virus were compared, normalization of
transaminase levels was less frequent in alcoholics with K1 (
glutamic oxaloacetic transaminase: 42.8%;
glutamic pyruvic transaminase: 28.6%) than in those with K2 (
glutamic oxaloacetic transaminase: 88.9%, p < 0.05;
glutamic pyruvic transaminase: 77.8%, P < 0.05). These data indicate that hepatitis C virus
infection is associated with a reduced rate of recovery of serum transminase levels following abstinence in subjects with
alcoholic liver disease, more so in the K1 subtype than in the K2 subtype.