Moderate alcohol consumption increases oxidative stress in patients with chronic hepatitis C

Hepatology. 2003 Jul;38(1):42-9. doi: 10.1053/jhep.2003.50275.


The mechanisms by which alcohol consumption worsens the evolution of chronic hepatitis C (CHC) are poorly understood. We have investigated the possible interaction between hepatitis C virus (HCV) and ethanol in promoting oxidative stress. Circulating IgG against human serum albumin (HSA) adducted with malondialdehyde (MDA-HSA), 4-hydroxynonenal (HNE-HSA), or arachidonic acid hydroperoxide (AAHP-HSA) and against oxidized cardiolipin (Ox-CL) were evaluated as markers of oxidative stress in 145 CHC patients with different alcohol consumption, 20 HCV-free heavy drinkers (HD) without liver disease, and 50 healthy controls. Anti-MDA IgG was increased in CHC patients irrespective of alcohol intake as well as in the HD group. CHC patients with moderate alcohol intake (<50 g ethanol/d), but not HD, also had significantly higher values of anti-AAHP-HSA, anti-HNE-HSA, and anti-Ox-CL IgG (P <.05) than controls. A further elevation (P <.001) of these antibodies was evident in CHC patients with heavy alcohol intake (>50 g ethanol/d). Anti-AAHP and anti-Ox-CL IgG above the 95th percentile in the controls were observed in 24% to 26% of moderate and 58% to 63% of heavy drinkers but only in 6% to 9% of the abstainers. The risk of developing oxidative stress during CHC was increased 3-fold by moderate and 13- to 24-fold by heavy alcohol consumption. Heavy drinking CHC patients had significantly more piecemeal necrosis and fibrosis than abstainers. Diffuse piecemeal necrosis was 4-fold more frequent among alcohol-consuming patients with lipid peroxidation-related antibodies than among those without these antibodies. In conclusion, even moderate alcohol consumption promotes oxidative stress in CHC patients, suggesting a role for oxidative injury in the worsening of CHC evolution by alcohol.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Alcohol Drinking / metabolism*
  • Aldehydes / immunology
  • Aldehydes / metabolism
  • Arachidonic Acid / immunology
  • Arachidonic Acid / metabolism
  • Autoantibodies / blood
  • Biomarkers
  • Cardiolipins / immunology
  • Cardiolipins / metabolism
  • Female
  • Hepatitis C, Chronic / complications
  • Hepatitis C, Chronic / metabolism*
  • Humans
  • Hydrogen Peroxide / immunology
  • Hydrogen Peroxide / metabolism
  • Immunoglobulin G / blood
  • Lipid Peroxidation
  • Male
  • Malondialdehyde / immunology
  • Malondialdehyde / metabolism
  • Middle Aged
  • Oxidative Stress*
  • Serum Albumin / immunology
  • Serum Albumin / metabolism


  • Aldehydes
  • Autoantibodies
  • Biomarkers
  • Cardiolipins
  • Immunoglobulin G
  • Serum Albumin
  • Arachidonic Acid
  • Malondialdehyde
  • Hydrogen Peroxide
  • 4-hydroxy-2-nonenal