Assessment of liver histology in chronic alcoholics with and without hepatitis C virus infection.

Patients with alcoholic liver disease have a high prevalence of hepatitis C virus (HCV) infection. The histological appearances of the liver in patients with alcoholic liver disease and HCV infection are well described. However, liver histology in individuals with dual pathology, both chronic alcohol abuse and HCV infection, is less well understood. The purpose of the present study was to examine this issue and to determine if there is any correlation between specific histological features and the serum biochemical abnormalities seen in these patients. Eighty-six chronic alcoholics, 65 with HCV infection and 21 uninfected subjects, were included in the study. All patients had history of heavy alcohol abuse (consuming 80 g or more of ethanol a day for at least 10 years). The following data were collected on each patient: demographic information (age, gender, race), the amount and duration of alcohol intake, biochemical results, and liver biopsy abnormalities including the histological activity index (HAI) score. HCV-infected alcoholics were younger (P = 0.05) and were more often African American than Caucasian (P < 0.01). Alcohol consumption was significantly greater in uninfected alcoholics compared to those with HCV infection (P < 0.05). Liver histology in subjects with HCV infection showed higher HAI scores for intralobular necrosis (P = 0.008) and periportal inflammation (P = 0.004). Features of "chronic hepatitis" and focal lymphoid aggregates were more frequent in HCV-infected alcoholics (P = 0.001 for each). By contrast, cirrhosis was present in a higher proportion of uninfected alcoholics compared to those with HCV infection (P = 0.05). Histological findings of hepatic fibrosis and total HAI score showed a significant correlation with serum albumin and platelet count in HCV-infected alcoholics. Chronic alcoholics with HCV infection have specific histological appearances that can usually help distinguish these patients from uninfected alcoholics. Correlation analysis indicates that of the various laboratory tests, serum albumin and platelet counts are the best predictors of the severity of liver damage at histology. In chronic alcoholics, the development of cirrhosis is related more to the amount of alcohol consumed than to the presence of HCV infection.

Interaction of alcohol and hepatitis C virus infection on severity of liver disease.

Chronic alcoholics have a high prevalence of hepatitis C virus (HCV) infection. The present study was carried out to examine the association between HCV infection and alcohol abuse, and the influence of these factors on the severity of liver disease. Patients with history of heavy alcohol abuse (> or = 80 g of ethanol per day for > or = 5 years) were analyzed with respect to the amount of alcohol use, clinical evidence of liver disease, and laboratory tests. One hundred ninety-nine patients, 137 HCV positive and 62 HCV negative were included in the study. HCV-infected subjects had liver disease for a longer duration (P < 0.0001) and had higher incidence of symptoms of hepatic decompensation in the past compared to uninfected alcoholics. Several differences were noted between the two groups at the time of presentation to the hospital. Alcoholics with HCV infection had lower daily alcohol consumption (P < 0.001), were abstinent for a longer duration (P < 0.02) and had lower lifetime use of ethanol (P < 0.005) compared to HCV-negative subjects. Assessment of liver tests showed greater derangement in uninfected alcoholics compared to HCV-positive subjects. The present study shows that HCV-infected chronic alcoholics have lower alcohol consumption and, perhaps as a consequence, have less severe liver disease compared to HCV-negative individuals. These findings suggest that in chronic alcoholics, despite the presence of HCV infection, the severity of liver damage is related to the amount of alcohol consumption.

Effects of monocular deprivation on the visual fields of squirrel monkeys.

Five squirrel monkeys were monocularly deprived at birth for 3 years. Visual field testing for the deprived eye revealed no responses to visual stimuli at any position, including the monocular segment. These results are similar to those obtained in macaque monkeys after long-term neonatal monocular deprivation and indicate that lack of patterned visual input to an eye during development in primates can produce functional blindness throughout the visual field. Because the monocular segment of the visual field was not spared, binocular competition cannot be the only mechanism underlying this loss. Instead, lack of patterned visual input probably causes improper neuronal connections during development in all segments of the visual cortex resulting in complete loss of form vision.