Published online Sep 14, 2014. doi: 10.3748/wjg.v20.i34.11929
Revised: March 25, 2014
Accepted: May 28, 2014
Published online: September 14, 2014
Processing time: 233 Days and 17.8 Hours
Hepatitis C virus (HCV) infection and alcohol abuse are two most important causes of chronic liver disease in the United States. Alcoholic hepatitis is a unique clinical syndrome among patients with chronic and active alcohol abuse with a potential for high short-term mortality. About 20% of patients presenting with alcoholic hepatitis have concomitant HCV infection. Mortality from alcoholic hepatitis is increased in the presence of concomitant hepatitis C due to synergistic interaction between HCV and alcohol in causing hepatocellular damage. Large prospective randomized studies are needed to develop guidelines on the use of corticosteroids among patients with alcoholic hepatitis and concomitant HCV infection. The impact of antiviral therapy on mortality and outcome in the setting of alcoholic hepatitis remains a novel area for future research.
Core tip: The article describes prevalence of hepatitis C virus infection and its impact on outcomes among patients with alcoholic hepatitis. The article deals with controversies and lack of guidelines on treating alcoholic hepatitis patients especially use of corticosteroids in this sick patient population.