Out of 287 chronic alcoholics, 21 of whom (7.32%) resulted HBsAg positive, 106 were tested for other serum HBV markers. An overall HBV prevalence of 55.66% was found. Cirrhotic patients were slightly older than non-cirrhotics (median age: 51 vs. 47), but the prevalence of both HBsAg and other HBV markers did not differ significantly between the two groups, neither among age classes. A relevant number of subjects (18.87%) had anti-HBc alone (or associated with anti-HBe) as the unique marker of HBV infection; this leads to some uncertainties in the evaluation of active viral disease. HBV positivity rate resulted significantly higher (p less than 0.01) in alcoholics than in two control groups, composed by health-care staff and open population (respectively 34% and 32.81% of positivity). Even if hepatitis B virus did not seem to affect directly the progress to liver cirrhosis in chronic alcoholics, a large number of patients seemed unable to clear the virus, whose importance in the development of chronic liver disease and hepatocellular carcinoma is well established. For these reasons, it seems advisable to include chronic alcoholics in high-risk groups that should be vaccinated against hepatitis B.
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