Efficacy and Long-Term Results of Combined Antiviral Treatment with Pegylated Interferon-Alpha-2a-Ribavirin for Chronic Hepatitis in Individuals with a Burdened Alcohol History

Abstract

The widespread prevalence of viral hepatitis C, the potential danger of progression of this disease with the development of liver cirrhosis and hepatocellular carcinoma, and the unsatisfactory effectiveness of currently developed antiviral therapy regimens dictate the need to search for new strategies for patient management in order to reduce the risk of severe liver damage. It has been established that a considerable proportion of HCV-infected patients are those with mixed, alcohol-viral liver damage. In such a situation, when examining and choosing the tactics of management, it is very important to assess the leading factor of liver damage, the degree of influence of alcohol consumed on the progression of hepatitis C and the results of antiviral therapy. Most studies that examined the effect of alcohol on the course of viral hepatitis C included groups of subjects who consumed alcohol daily in high doses (more than 50 g/day). It has been proven that alcohol abuse is associated with an increased frequency of adverse outcomes of HCV infection (increased risk of developing liver cirrhosis and hepatocellular carcinoma), high levels of viremia, and low efficacy of antiviral therapy. It has been convincingly demonstrated that high-dose ethanol intake stimulates fibrogenesis and HCV RNA replication. The percentage of patients who did not respond to interferon therapy is higher among drinkers than in non-drinkers. Possible explanations for this may be the secretion of inflammatory substances (cytokines) under the influence of alcohol, interfering with the virus-host interaction and the control of inflammation.