BACKGROUND AND AIM: The natural history of alcoholic cirrhosis, especially in Asian countries, has not been completely understood thus far. METHODS: We retrospectively compared the outcomes of compensated cirrhosis between Japanese alcoholic and hepatitis C virus (HCV)-infected patients. RESULTS: A total of 227 patients (75 alcoholic and 152 HCV-infected patients) with compensated cirrhosis were enrolled. The median follow-up period was 4.9 years. The cumulative rates of hepatocellular carcinoma (HCC) development were significantly lower in the alcoholic patients than in the HCV-infected patients (6.8% vs 50.3% at 10 years, P = 0.0003), while the cumulative rates of hepatic decompensation (37.4% vs 51.7% at 10 years) and survival (53.8% vs 47.4% at 10 years) did not significantly differ between the two groups (Kaplan-Meir analysis). The main causes of death were hepatic failure and non-hepatic diseases in the alcoholic patients and HCC and hepatic failure in the HCV-infected patients. Multivariate analyses using the Cox proportional hazard model revealed that the risk of HCC was lower in alcoholic cirrhosis than in HCV-related cirrhosis (hazard ratio (HR), 0.46), while the risk of hepatic decompensation and mortality was the same. Predictors of decreased survival were non-abstinence (HR, 2.53) in the alcoholic patients and low serum albumin level (1.58) in the HCV-infected patients. CONCLUSIONS: Survival of patients with alcoholic cirrhosis was similar to that of patients with HCV-related cirrhosis. The risk of HCC development was lower in alcoholic cirrhosis than in HCV-related cirrhosis. Abstinence from alcohol was important for improving the survival of patients with alcoholic cirrhosis.
BACKGROUND AND AIM: The natural history of alcoholic cirrhosis, especially in Asian countries, has not been completely understood thus far. METHODS: We retrospectively compared the outcomes of compensated cirrhosis between Japanese alcoholic and hepatitis C virus (HCV)-infectedpatients. RESULTS: A total of 227 patients (75 alcoholic and 152 HCV-infectedpatients) with compensated cirrhosis were enrolled. The median follow-up period was 4.9 years. The cumulative rates of hepatocellular carcinoma (HCC) development were significantly lower in the alcoholic patients than in the HCV-infectedpatients (6.8% vs 50.3% at 10 years, P = 0.0003), while the cumulative rates of hepatic decompensation (37.4% vs 51.7% at 10 years) and survival (53.8% vs 47.4% at 10 years) did not significantly differ between the two groups (Kaplan-Meir analysis). The main causes of death were hepatic failure and non-hepatic diseases in the alcoholicpatients and HCC and hepatic failure in the HCV-infectedpatients. Multivariate analyses using the Cox proportional hazard model revealed that the risk of HCC was lower in alcoholic cirrhosis than in HCV-related cirrhosis (hazard ratio (HR), 0.46), while the risk of hepatic decompensation and mortality was the same. Predictors of decreased survival were non-abstinence (HR, 2.53) in the alcoholic patients and low serum albumin level (1.58) in the HCV-infectedpatients. CONCLUSIONS: Survival of patients with alcoholic cirrhosis was similar to that of patients with HCV-related cirrhosis. The risk of HCC development was lower in alcoholic cirrhosis than in HCV-related cirrhosis. Abstinence from alcohol was important for improving the survival of patients with alcoholic cirrhosis.
Authors: Adrian M Di Bisceglie; Anne M Stoddard; Jules L Dienstag; Mitchell L Shiffman; Leonard B Seeff; Herbert L Bonkovsky; Chihiro Morishima; Elizabeth C Wright; Kristin K Snow; William M Lee; Robert J Fontana; Timothy R Morgan; Marc G Ghany Journal: Hepatology Date: 2011-04 Impact factor: 17.425
Authors: Kasper J Andersen; Henning Grønbaek; Gerda Elisabeth Villadsen; Anders Riegels Knudsen; Peter Ott; Hendrik Vildstrup; Dennis Tønner Nielsen; Arindam Bharadwaz Journal: Indian J Gastroenterol Date: 2013-12-04