Alcoholic liver disease confers a worse prognosis than HCV infection and non-alcoholic fatty liver disease among patients with cirrhosis: An observational study.

Détails

Ressource 1Télécharger: 29077714_BIB_385BD919A253.pdf (1397.60 [Ko])
Etat: Public
Version: Final published version
Licence: CC BY 4.0
ID Serval
serval:BIB_385BD919A253
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Alcoholic liver disease confers a worse prognosis than HCV infection and non-alcoholic fatty liver disease among patients with cirrhosis: An observational study.
Périodique
PloS one
Auteur⸱e⸱s
Marot A., Henrion J., Knebel J.F., Moreno C., Deltenre P.
ISSN
1932-6203 (Electronic)
ISSN-L
1932-6203
Statut éditorial
Publié
Date de publication
2017
Peer-reviewed
Oui
Volume
12
Numéro
10
Pages
e0186715
Langue
anglais
Notes
Publication types: Journal Article ; Observational Study
Publication Status: epublish
Résumé
Cirrhosis is a heterogeneous clinical condition that includes patients at wide-ranging stages of severity. The role of the underlying liver disease on patient prognosis remains unclear.
To assess the impact of the underlying liver disease on the occurrence of hepatocellular carcinoma (HCC) and death.
Data related to the occurrence of HCC and death were collected during a 21-year period among patients with cirrhosis related to alcoholic liver disease (ALD) (n = 529), chronic hepatitis C virus (HCV) infection (n = 145) or non-alcoholic fatty liver disease (NAFLD) (n = 78).
At inclusion, ALD patients were younger than HCV and NAFLD patients (56 vs. 67 vs. 63 years; p<0.001) and had worse liver function (percent of patients with Child-Pugh stages B or C: 48% vs. 8% vs. 17%; p<0.001). During follow-up, 85 patients developed HCC and 379 died. The 10-year cumulative incidence rate of HCC was lower in ALD patients than in HCV and NAFLD patients (8.4% vs. 22.0% vs. 23.7%; p<0.001). The 10-year cumulative incidence rates of mortality were not statistically different between ALD, HCV and NAFLD patients (58.1% vs. 47.7% vs. 49.9%; p = 0.078). Alcohol abstinence and viral eradication were associated with reduced mortality among ALD and HCV patients, respectively. In multivariate analyses, ALD was associated with a reduced risk of HCC (0.39; 95% CI, 0.20-0.76; p = 0.005) but with a higher risk of mortality (1.53; 95% CI, 1.20-1.95; p<0.001). ALD patients died more frequently from decompensation of cirrhosis.
Despite a lower incidence of HCC, patients with ALD-related cirrhosis have a worse outcome than those with chronic HCV infection or NAFLD-related cirrhosis.

Mots-clé
Aged, Carcinoma, Hepatocellular/complications, Cause of Death, Female, Hepatitis C/complications, Hepatitis C/pathology, Humans, Liver Cirrhosis, Alcoholic/complications, Liver Cirrhosis, Alcoholic/pathology, Liver Diseases, Alcoholic/complications, Liver Diseases, Alcoholic/pathology, Liver Neoplasms/complications, Liver Transplantation, Male, Middle Aged, Non-alcoholic Fatty Liver Disease/complications, Non-alcoholic Fatty Liver Disease/pathology, Prognosis
Pubmed
Web of science
Open Access
Oui
Création de la notice
09/11/2017 18:29
Dernière modification de la notice
20/08/2019 13:27
Données d'usage