Academic journal article Alcohol Research: Current Reviews

Alcohol and Viral Hepatitis: Role of Lipid Rafts

Academic journal article Alcohol Research: Current Reviews

Alcohol and Viral Hepatitis: Role of Lipid Rafts

Article excerpt

Both alcohol abuse and infection with hepatitis viruses can lead to liver disease, including chronic hepatitis. Alcohol and hepatitis viruses have synergistic effects in the development of liver disease. Some of these involve the cellular membranes and particularly their functionally active domains, termed lipid rafts, which contain many proteins with essential roles in signaling and other processes. These lipid rafts play a central role in the lifecycles of hepatitis viruses. Alcohol's actions at the lipid rafts may contribute to the synergistic harmful effects of alcohol and hepatitis viruses on the liver and the pathogenesis of liver disease.

Key words: Alcohol abuse; alcohol use and misuse; alcohol disorder; liver; liver disease; hepatitis; hepatitis B virus; hepatitis C virus; lipid rafts

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Alcohol is the most used and abused psychoactive drug worldwide. Alcohol use and misuse, including alcohol use disorder, can have devastating effects and account for 5.9 percent of deaths and 5.1 percent of the global burden of disease and injury, thereby also imposing a significant social and economic burden on society (World Health Organization 2015). Moreover, treatments for alcohol abuse have shown limited effectiveness (Grant et al. 1988; National Institute on Alcohol Abuse and Alcoholism 1998). Alcohol use disorder is a systemic disease that affects all organs and systems. Evidence suggests that risk of alcohol-related organ damage occurs with excessive alcohol intake, which is defined as binge drinking or heavy drinking. According to the National Institute on Alcohol Abuse and Alcoholism, binge drinking is defined as a pattern of alcohol consumption that brings the blood alcohol concentration (BAC) level to 0.08 percent or more. This pattern of drinking usually corresponds to consumption of 5 or more drinks on a single occasion for men and 4 or more drinks on a single occasion for women, generally within about 2 hours. Heavy drinking typically is defined as consuming 15 drinks or more per week for men and 8 drinks or more per week for women (Centers for Disease Control and Prevention [CDC] 2014). The liver is particularly susceptible to alcohol-induced damage. However, although many chronic heavy drinkers develop alcoholic liver disease (ALD), no consumption levels have been identified that predictably result in ALD. Factors that influence the susceptibility to ALD include gender, co-exposure to other drugs, genetic factors that either favor the development of addiction or affect alcohol-metabolizing enzymes, immunological factors, nutritional status, and infection with viruses targeting the liver (i.e., hepatotropic viruses).

Hepatitis viruses, and particularly hepatitis B virus (HBV) and hepatitis C virus (HCV), are responsible for most cases of chronic hepatitis in the United States. In 2013, almost 20,000 new cases of HBV infection and almost 30,000 new cases of HCV infection were estimated to occur in the United States (CDC 2015a). Worldwide, approximately 350 to 400 million people, or about 5 percent of the population, are chronically infected with HBV and about 180 million people, or 2 percent of the population, with HCV (El-Serag 2012). In chronic alcoholics, the prevalence of HCV infection as indicated by the presence of anti-HCV antibodies is higher than in the general population (Takase et al. 1993). Co-occurring viral hepatitis and alcohol use disorder adversely affect disease course and are associated with increased mortality and death at an earlier age (Kim et al. 2001; Sagnelli et al. 2012; Tsui et al. 2006; Wiley et al. 1998). The most serious complication of ALD is liver cirrhosis, which often progresses to hepatocellular carcinoma (HCC); indeed, about 20 percent of heavy drinkers develop cirrhosis during their lifetime, and this risk is much increased in the presence of co-occurring viral hepatitis (El-Serag 2012; Ishak et al. 1991). End-stage liver disease from viral hepatitis, together with ALD, is the main reason for liver transplantation in the United States (El-Serag 2012). …

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