Comparison of outcomes between patients with alcoholic cirrhosis and those with hepatitis C virus-related cirrhosis
Article first published online: 6 APR 2009
© 2009 The Authors. Journal compilation © 2009 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd
Journal of Gastroenterology and Hepatology
Volume 24, Issue 7, pages 1276–1283, July 2009
How to Cite
Toshikuni, N., Izumi, A., Nishino, K., Inada, N., Sakanoue, R., Yamato, R., Suehiro, M., Kawanaka, M. and Yamada, G. (2009), Comparison of outcomes between patients with alcoholic cirrhosis and those with hepatitis C virus-related cirrhosis. Journal of Gastroenterology and Hepatology, 24: 1276–1283. doi: 10.1111/j.1440-1746.2009.05851.x
- Issue published online: 29 JUL 2009
- Article first published online: 6 APR 2009
- Accepted for publication 3 February 2009.
- compensated liver cirrhosis;
- hepatitis C virus;
- natural history
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.