Abstract: Objective To determine the impact of alcohol use on the clinical progression and outcome in patients with hepatitis C virus(HCV) infection. Methods A retrospective comparative analysis was performed in alcohol non-drinkers and drinkers to assess the variations of chronic hepatitis C patients in the clinical tests, virology, and prognosis. Results A total of 162 patients were enrolled. Of these, 99 were non-drinkers, 34 were mild drinkers, and 29 were heavy drinkers. The median clinical course of disease of the 3 groups were 12 years, 9 years, and 8 years(P=0.005). The test results of alanine transaminase(ALT), aspartate transaminase(AST), gamma-glutamyl transferase(GGT), total bilirubin(TBIL) and mean corpuscular volume(MCV) had a significant difference between non-drinkers and mild or severe drinkers (P<0.05). There was a higher rate of high HCV-RNA load in heavy drinkers compared with the non-drinkers(31.0% and 14.1%, P=0.037). Cirrhosis was proved 32.3%(32 persons) in non-drinkers, 43.3%(13 persons) in mild drinkers, and 62.1%(18 persons) in heavy drinkers(P=0.015). The mortality rate was 4.0%(2 persons) in non-drinkers, 5.9%(2 persons) in mild drinkers, and 17.2%(5 persons) in heavy drinkers(P=0.000). However, there was no significant difference on the morbidity of liver cancer between non-drinkers and drinkers. Conclusion Alcohol consumption could aggravate the hepatic lesions, accelerate the clinical progression, and increase the morbidity and mortality of cirrhosis in chronic HCV patients. In addition, large amount of alcohol consumption may increase HCV replication.

Key words: chronic hepatitis C infection, alcohol, hepatic lesion, cirrhosis, hepatic cell cancer