Comparison of outcomes between patients with alcoholic cirrhosis and those with hepatitis C virus-related cirrhosis

J Gastroenterol Hepatol. 2009 Jul;24(7):1276-83. doi: 10.1111/j.1440-1746.2009.05851.x. Epub 2009 Apr 6.

Abstract

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.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Asian People / statistics & numerical data
  • Carcinoma, Hepatocellular / etiology*
  • Carcinoma, Hepatocellular / mortality
  • Carcinoma, Hepatocellular / virology
  • Cause of Death
  • Disease Progression
  • Female
  • Hepatitis C / complications*
  • Hepatitis C / ethnology
  • Hepatitis C / mortality
  • Humans
  • Japan / epidemiology
  • Kaplan-Meier Estimate
  • Liver Cirrhosis / complications
  • Liver Cirrhosis / ethnology
  • Liver Cirrhosis / mortality
  • Liver Cirrhosis / virology*
  • Liver Cirrhosis, Alcoholic / complications*
  • Liver Cirrhosis, Alcoholic / ethnology
  • Liver Cirrhosis, Alcoholic / mortality
  • Liver Failure / etiology*
  • Liver Failure / mortality
  • Liver Failure / virology
  • Liver Neoplasms / etiology*
  • Liver Neoplasms / mortality
  • Liver Neoplasms / virology
  • Male
  • Middle Aged
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Temperance
  • Time Factors