BACKGROUND & AIMS: We examined the prevalence and clinical characteristics of alcohol-induced liver disease (ALD) in patients referred to a tertiary care center and examined the interaction between ALD and hepatitis C virus (HCV) in a longitudinal survival model. METHODS: A total of 1611 patients with chronic liver disease referred to a tertiary care center between 1994 and 2001 were analyzed. The survival of ALD, HCV, and the combination of the 2 (ALD + HCV) was compared in cirrhotic and precirrhotic patients by using Kaplan-Meier estimates. A Cox proportional hazards model was used to examine the independent effects of predictors on survival. RESULTS: ALD comprised 31% of the cohort, ALD + HCV comprised 14%, HCV comprised 22%, and the rest comprised 33%. The survival of precirrhotic patients with HCV was significantly better than the survival of those with ALD (hazard ratio, 0.27; P = 0.0006) over long-term and 1-year (hazard ratio, 0.24; P = 0.016) follow-up periods. There was no difference in survival between patients with ALD and ALD + HCV ( P = 0.62). In patients with cirrhosis, survival did not differ by cause; decompensated liver disease (hazard ratio, 1.67; P = 0.004) and continued alcohol abuse (hazard ratio, 2.19; P = 0.002) predicted worse survival in this group. CONCLUSIONS: ALD with HCV remains a prevalent cause of chronic liver disease in patients referred to a U.S. tertiary care center. In patients with ALD, the addition of HCV does not change survival, suggesting alcoholism is the driving force for mortality in patients coming to clinical attention. In patients with cirrhosis, ongoing excessive alcohol use and complications of end-stage liver disease drive mortality, irrespective of the underlying cause of chronic liver disease.
BACKGROUND & AIMS: We examined the prevalence and clinical characteristics of alcohol-induced liver disease (ALD) in patients referred to a tertiary care center and examined the interaction between ALD and hepatitis C virus (HCV) in a longitudinal survival model. METHODS: A total of 1611 patients with chronic liver disease referred to a tertiary care center between 1994 and 2001 were analyzed. The survival of ALD, HCV, and the combination of the 2 (ALD + HCV) was compared in cirrhotic and precirrhotic patients by using Kaplan-Meier estimates. A Cox proportional hazards model was used to examine the independent effects of predictors on survival. RESULTS:ALD comprised 31% of the cohort, ALD + HCV comprised 14%, HCV comprised 22%, and the rest comprised 33%. The survival of precirrhotic patients with HCV was significantly better than the survival of those with ALD (hazard ratio, 0.27; P = 0.0006) over long-term and 1-year (hazard ratio, 0.24; P = 0.016) follow-up periods. There was no difference in survival between patients with ALD and ALD + HCV ( P = 0.62). In patients with cirrhosis, survival did not differ by cause; decompensated liver disease (hazard ratio, 1.67; P = 0.004) and continued alcohol abuse (hazard ratio, 2.19; P = 0.002) predicted worse survival in this group. CONCLUSIONS:ALD with HCV remains a prevalent cause of chronic liver disease in patients referred to a U.S. tertiary care center. In patients with ALD, the addition of HCV does not change survival, suggesting alcoholism is the driving force for mortality in patients coming to clinical attention. In patients with cirrhosis, ongoing excessive alcohol use and complications of end-stage liver disease drive mortality, irrespective of the underlying cause of chronic liver disease.
Authors: Winston Dunn; Paul Angulo; Schuyler Sanderson; Laith H Jamil; Linda Stadheim; Charles Rosen; Michael Malinchoc; Patrick S Kamath; Vijay H Shah Journal: Gastroenterology Date: 2006-08-10 Impact factor: 22.682
Authors: Anna S Lok; Leonard B Seeff; Timothy R Morgan; Adrian M di Bisceglie; Richard K Sterling; Teresa M Curto; Gregory T Everson; Karen L Lindsay; William M Lee; Herbert L Bonkovsky; Jules L Dienstag; Marc G Ghany; Chihiro Morishima; Zachary D Goodman Journal: Gastroenterology Date: 2008-09-18 Impact factor: 22.682
Authors: Manuela G Neuman; Samuel W French; Barbara A French; Helmut K Seitz; Lawrence B Cohen; Sebastian Mueller; Natalia A Osna; Kusum K Kharbanda; Devanshi Seth; Abraham Bautista; Kyle J Thompson; Iain H McKillop; Irina A Kirpich; Craig J McClain; Ramon Bataller; Radu M Nanau; Mihai Voiculescu; Mihai Opris; Hong Shen; Brittany Tillman; Jun Li; Hui Liu; Paul G Thomes; Murali Ganesan; Steve Malnick Journal: Exp Mol Pathol Date: 2014-09-11 Impact factor: 3.362
Authors: Ashwani K Singal; Habeeb Salameh; Anjna Singal; Sarat C Jampana; Daniel H Freeman; Karl E Anderson; Don Brunder Journal: World J Gastrointest Pharmacol Ther Date: 2013-05-06