Retrospective analysis of the impact of HIV infection and alcohol use on chronic hepatitis C in a large cohort of drug users

J Hepatol. 1998 Jun;28(6):945-50. doi: 10.1016/s0168-8278(98)80341-3.


Background/aim: This retrospective study aimed to better define the respective biological and pathological impact of human immunodeficiency virus infection and chronic alcohol consumption on the course of hepatitis C virus infection in intravenous drug users.

Methods: Two hundred and ten consecutive anti-HCV positive intravenous drug users, among whom 60 were also anti-HIV positive, took part in the study at the University Hospital, Paris, France.

Results: The activity of aspartate aminotransferase and gamma-glutamyl transpeptidase was significantly increased in serum from anti-HIV positive patients. The mean hepatitis activity index was significantly higher in anti-HIV positive patients (p<0.05), among whom there was also a higher proportion of patients with cirrhosis as compared to anti-HIV negative patients (30.0 vs 15.3%, p<0.0001). Excessive alcohol drinking (recorded in around 35% of the patients, whatever their HIV status), as compared to non-excessive drinking, was more often associated with cirrhosis in anti-HIV negative (24.5 vs 11.3%, p<0.05) than in anti-HIV positive patients (30.4 vs 29.7%, not significant). In a multivariate analysis, HIV infection (relative risk 2.2, confidence interval 1.1-4.5) and excessive alcohol drinking (relative risk 1.9, confidence interval 1.0-3.9) were the variables independently associated with the risk of cirrhosis.

Conclusion: Human immunodeficiency virus infection worsens the course of chronic hepatitis C in intravenous drug users. Excessive alcohol drinking also appears to be a crucial negative cofactor, and therefore alcohol withdrawal should be proposed as an integral part of the therapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Alanine Transaminase / blood
  • Alcohol Drinking*
  • Alcoholism / complications*
  • Alcoholism / physiopathology
  • Aspartate Aminotransferases / blood
  • Cohort Studies
  • Female
  • Genotype
  • HIV Infections / complications
  • HIV Infections / physiopathology*
  • Hepacivirus / genetics
  • Hepacivirus / isolation & purification
  • Hepatitis C Antibodies / blood
  • Hepatitis C, Chronic / complications
  • Hepatitis C, Chronic / pathology
  • Hepatitis C, Chronic / physiopathology*
  • Humans
  • Male
  • Paris
  • RNA, Viral / blood
  • Retrospective Studies
  • Substance Abuse, Intravenous*
  • gamma-Glutamyltransferase / blood


  • Hepatitis C Antibodies
  • RNA, Viral
  • gamma-Glutamyltransferase
  • Aspartate Aminotransferases
  • Alanine Transaminase