Hepatitis refers to inflammation of the liver. Several things can lead to the condition — one major cause is hepatitis C, which can result from a viral infection. Another is alcohol consumption, which can cause alcoholic hepatitis.
These two types of hepatitis are separate conditions. However, alcohol consumption and the hepatitis C virus (HCV) also have associations with one another.
According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), HCV infection appears to be more prevalent among people with alcohol abuse disorder. Consuming alcohol also worsens HCV and can interfere with its treatment.
Keep reading to learn more about the association between hepatitis C and alcohol, as well as symptoms, diagnosis, and treatment of alcoholic hepatitis.
No, it is not possible to get hepatitis C from alcohol. This condition results from a viral infection, which a person can only contract if they have exposure to blood containing HCV.
However, excessive alcohol consumption may raise the risk of acquiring HCV. According to the NIAAA, research from the 1990s found that people with alcohol abuse disorder had higher rates of HCV than the control group. This was true even for individuals with no other HCV risk factors.
Scientists are not sure why HCV is more common in those who consume excess alcohol. However, some believe alcohol makes it easier for the virus to enter and remain inside the body.
When a person contracts HCV, it can cause an acute or short-term illness, or it can become chronic. Around
Alcohol also appears to worsen existing HCV infections. For example, individuals with chronic HCV often develop liver scarring. Generally, a person with HCV has a 20% risk of liver scarring that develops into severe scarring, or cirrhosis, over time.
However, because alcohol promotes liver scarring, an individual with HCV who drinks heavily has 16 times the risk of cirrhosis than someone with this virus who does not drink. If HCV causes cirrhosis, it can cause liver failure or cancer.
People who drink alcohol can still develop liver inflammation and injury, even if they never contract HCV. This is because excessive alcohol consumption can lead to alcoholic hepatitis.
Alcoholic hepatitis is a separate condition from HCV — it is a severe consequence of long-term alcohol abuse that lasts at least 20 years.
Alcoholic hepatitis is especially common in those who:
- drink large amounts of alcohol
- drink outside of mealtimes
- have malnutrition
Hepatitis due to both HCV and alcohol abuse can coexist. According to a 2018 article, it is common for the two conditions to occur simultaneously.
Excessive alcohol consumption can accelerate and multiply the damage due to HCV, worsening liver cirrhosis. However, even small amounts of alcohol can exacerbate HCV. It may also interfere with HCV treatment by causing the virus to become resistant to medication.
Although both conditions are responsible for liver inflammation, there are differences in the symptoms of HCV and alcoholic hepatitis.
According to the World Health Organization (WHO), around
Individuals who do experience hepatitis C symptoms may develop:
- low appetite
- abdominal pain
- joint pain
- dark-colored urine
- grey feces
- jaundice, which causes yellowing of the skin and whites of the eyes
By contrast, alcoholic hepatitis causes the
- malaise, or a general feeling of not being well
- low appetite
- tenderness in the liver
- systemic inflammatory response syndrome, which involves fever, fast heart rate, and fast breathing
It is important to note that HCV is contagious. If a person is unsure if they have contracted the infection, they should take safety precautions to prevent others from coming into contact with their blood.
Doctors can diagnose HCV via blood tests. The first test detects HCV antibodies in the blood, which will be present if someone has had HCV previously. If this test is positive, healthcare professionals will use a second blood test to see if the virus has caused a chronic infection.
Diagnosing alcoholic hepatitis can be less certain, as there is no diagnostic test for this condition. Doctors base a diagnosis on the following:
- a history of excessive alcohol consumption
- symptoms of liver disease
- CT or MRI scans, which help rule out other causes of liver disease and help identify cirrhosis
- enzyme liver function tests
- biopsy to assess the severity of fat and fibrosis in the liver
Doctors treat chronic HCV using direct-acting antiviral drugs, which can cure
However, it is also important to stop drinking before treatments begin, as alcohol may reduce the effectiveness of some antivirals.
For alcoholic hepatitis, abstinence from alcohol is the highest priority for treatment, involving stopping alcohol consumption entirely. Ceasing drinking is the most effective way to reduce the risk of further liver damage, and if someone can do this early in the disease, it may reverse its effects. However, once an individual develops cirrhosis, this damage becomes permanent.
Most people with alcoholic hepatitis need to stay in the hospital. They then may begin a treatment or support program to help them address addiction.
Other measures that may help someone minimize liver damage as a result of alcohol consumption include the below.
People who drink large amounts of alcohol tend to have malnutrition due to a lack of calories or nutrients. Treating malnutrition can reverse some of the effects of alcoholic hepatitis. Some individuals may need a feeding tube, while others may benefit from eating a high-protein diet comprising:
- meat, fish, and seafood
- nuts and beans
- milk, cheese, eggs, and yogurt
- whole grains, such as oatmeal, brown rice, and whole grain bread
A dietitian can help a person address their nutritional needs and follow a balanced diet.
People with alcohol-related hepatitis may be able to take drugs that lower inflammation, such as steroids. This can reduce the risk of further scarring. However, as steroids can have serious side effects, a doctor may prescribe pentoxifylline (Trental) if someone cannot tolerate them.
If a person with HCV or alcoholic hepatitis does not seek treatment, it can lead to serious complications.
Chronic, untreated HCV can cause liver scarring, liver failure, and cancer, while the complications of alcoholic hepatitis can include:
- continued scarring
- decreased liver function
- enlarged veins in the esophagus, which can cause serious internal bleeding
- kidney failure
- brain damage or coma from the accumulation of toxins in the blood
Anyone who suspects they may have a liver condition should speak with a doctor as soon as possible. The sooner a healthcare professional diagnoses liver conditions, such as HCV and alcoholic hepatitis, the earlier treatment can begin. This may reduce the risk of permanent liver damage and complications.
Individuals can also speak with a doctor or a support organization if they find it difficult to reduce their alcohol consumption.
Alcohol consumption does not cause HCV, although excessive use may increase the risk of developing a chronic HCV infection. It can also worsen HCV by contributing to liver damage.
Even if an individual does not have HCV, excess alcohol consumption can lead to alcoholic hepatitis. Whether a person’s hepatitis is due to excess alcohol consumption or HCV, the condition can have very serious complications if it progresses to its advanced stages.
People can speak with a doctor if they have any concerns about hepatitis, alcohol consumption, or the impact it is having on their liver.