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Effect of alcohol on clinical complications of hepatitis virus-induced liver cirrhosis: a consecutive ten-year study

BACKGROUND AND AIMS: Although coexisting alcohol-induced liver disease and hepatitis B or C virus-induced liver cirrhosis (ALD + HBV or ALD + HCV) has been the center of recent hepatology researches, numerous controversies still persist. This study aimed to showcase the influence of alcohol on the l...

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Autores principales: Abassa, Kodjo-Kunale, Wu, Xiao-Ying, Xiao, Xiu-Ping, Zhou, Hao-Xiong, Guo, Yun-Wei, Wu, Bin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8934474/
https://www.ncbi.nlm.nih.gov/pubmed/35305565
http://dx.doi.org/10.1186/s12876-022-02198-w
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author Abassa, Kodjo-Kunale
Wu, Xiao-Ying
Xiao, Xiu-Ping
Zhou, Hao-Xiong
Guo, Yun-Wei
Wu, Bin
author_facet Abassa, Kodjo-Kunale
Wu, Xiao-Ying
Xiao, Xiu-Ping
Zhou, Hao-Xiong
Guo, Yun-Wei
Wu, Bin
author_sort Abassa, Kodjo-Kunale
collection PubMed
description BACKGROUND AND AIMS: Although coexisting alcohol-induced liver disease and hepatitis B or C virus-induced liver cirrhosis (ALD + HBV or ALD + HCV) has been the center of recent hepatology researches, numerous controversies still persist. This study aimed to showcase the influence of alcohol on the laboratory values and on the clinical outcomes of patients with hepatitis B and C virus-induced liver cirrhosis. METHODS: Patients diagnosed with liver cirrhosis (n = 22,287) from January 2010 to December 2019 were enrolled, and divided into five groups according to the etiology: alcohol-induced liver disease (ALD, 1652 cases), hepatitis B virus (HBV, 18,079 cases), hepatitis C virus (HCV, 682 cases), ALD + HBV (1594 cases) and ALD + HCV (280 cases). Laboratory results and proportion of different liver cirrhosis complications were contrasted between groups. RESULTS: The proportions of patients with Child Pugh grade C (28.0% vs 18.8%, P < 0.001) or MELD greater than 18 (24.1% vs 18.5%, P < 0.001) in the ALD + HBV group exceeded significantly those in the HBV group. Multivariate logistic regression revealed that the risk of hepatocellular carcinoma (HCC) and that of esophageal gastric variceal bleeding (EGVB) in the ALD + HBV group was respectively 2.01-fold and 1.74-fold that in the HBV group (HCC: OR = 2.01, 95% CI [1.58–2.55]; EGVB: OR = 1.74, 95% CI [1.30–2.33]) after adjusting for potential confounders. Furthermore, a linear-by-linear analysis test showed a decrease in the risk of HCC and EGVB with the duration of alcohol abstinence. Moreover, patients with both antiviral treatment and alcohol abstinence had the lowest risk of HCC and EGVB (HCC: OR = 0.10, 95% CI [0.05–0.20], P < 0.001; EGVB: OR = 0.17, 95% CI [0.06–0.45], P < 0.001) compared to those without any treatment, those with abstinence alone and those with antiviral therapy alone. Similar pattern was noticed while comparing the ALD + HCV group to the HCV group. CONCLUSION: Heavy alcohol use increased the severity of liver function impairment and the prevalence of HCC and EGVB in hepatitis virus-induced liver cirrhosis patients. Remarkably, long-term alcohol abstinence coupled with antiviral treatment effectively decreased the risk of HCC and EGVB in these populations. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12876-022-02198-w.
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spelling pubmed-89344742022-03-23 Effect of alcohol on clinical complications of hepatitis virus-induced liver cirrhosis: a consecutive ten-year study Abassa, Kodjo-Kunale Wu, Xiao-Ying Xiao, Xiu-Ping Zhou, Hao-Xiong Guo, Yun-Wei Wu, Bin BMC Gastroenterol Research BACKGROUND AND AIMS: Although coexisting alcohol-induced liver disease and hepatitis B or C virus-induced liver cirrhosis (ALD + HBV or ALD + HCV) has been the center of recent hepatology researches, numerous controversies still persist. This study aimed to showcase the influence of alcohol on the laboratory values and on the clinical outcomes of patients with hepatitis B and C virus-induced liver cirrhosis. METHODS: Patients diagnosed with liver cirrhosis (n = 22,287) from January 2010 to December 2019 were enrolled, and divided into five groups according to the etiology: alcohol-induced liver disease (ALD, 1652 cases), hepatitis B virus (HBV, 18,079 cases), hepatitis C virus (HCV, 682 cases), ALD + HBV (1594 cases) and ALD + HCV (280 cases). Laboratory results and proportion of different liver cirrhosis complications were contrasted between groups. RESULTS: The proportions of patients with Child Pugh grade C (28.0% vs 18.8%, P < 0.001) or MELD greater than 18 (24.1% vs 18.5%, P < 0.001) in the ALD + HBV group exceeded significantly those in the HBV group. Multivariate logistic regression revealed that the risk of hepatocellular carcinoma (HCC) and that of esophageal gastric variceal bleeding (EGVB) in the ALD + HBV group was respectively 2.01-fold and 1.74-fold that in the HBV group (HCC: OR = 2.01, 95% CI [1.58–2.55]; EGVB: OR = 1.74, 95% CI [1.30–2.33]) after adjusting for potential confounders. Furthermore, a linear-by-linear analysis test showed a decrease in the risk of HCC and EGVB with the duration of alcohol abstinence. Moreover, patients with both antiviral treatment and alcohol abstinence had the lowest risk of HCC and EGVB (HCC: OR = 0.10, 95% CI [0.05–0.20], P < 0.001; EGVB: OR = 0.17, 95% CI [0.06–0.45], P < 0.001) compared to those without any treatment, those with abstinence alone and those with antiviral therapy alone. Similar pattern was noticed while comparing the ALD + HCV group to the HCV group. CONCLUSION: Heavy alcohol use increased the severity of liver function impairment and the prevalence of HCC and EGVB in hepatitis virus-induced liver cirrhosis patients. Remarkably, long-term alcohol abstinence coupled with antiviral treatment effectively decreased the risk of HCC and EGVB in these populations. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12876-022-02198-w. BioMed Central 2022-03-19 /pmc/articles/PMC8934474/ /pubmed/35305565 http://dx.doi.org/10.1186/s12876-022-02198-w Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Abassa, Kodjo-Kunale
Wu, Xiao-Ying
Xiao, Xiu-Ping
Zhou, Hao-Xiong
Guo, Yun-Wei
Wu, Bin
Effect of alcohol on clinical complications of hepatitis virus-induced liver cirrhosis: a consecutive ten-year study
title Effect of alcohol on clinical complications of hepatitis virus-induced liver cirrhosis: a consecutive ten-year study
title_full Effect of alcohol on clinical complications of hepatitis virus-induced liver cirrhosis: a consecutive ten-year study
title_fullStr Effect of alcohol on clinical complications of hepatitis virus-induced liver cirrhosis: a consecutive ten-year study
title_full_unstemmed Effect of alcohol on clinical complications of hepatitis virus-induced liver cirrhosis: a consecutive ten-year study
title_short Effect of alcohol on clinical complications of hepatitis virus-induced liver cirrhosis: a consecutive ten-year study
title_sort effect of alcohol on clinical complications of hepatitis virus-induced liver cirrhosis: a consecutive ten-year study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8934474/
https://www.ncbi.nlm.nih.gov/pubmed/35305565
http://dx.doi.org/10.1186/s12876-022-02198-w
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