Alcohol intake increases the risk of HCC in hepatitis C virus-related cirrhosis: a prospective study.

[en] Background & Aims:Whether alcohol intake increases the risk of complications in patients with HCV-related cirrhosis remains unclear. The aim of this study was to determine the impact of alcohol intake and viral eradication on the risk of hepatocellular carcinoma (HCC), decompensation of cirrhosis and death. Methods: Data on alcohol intake and viral eradication were prospectively collected in 192 patients with compensated HCVrelated cirrhosis. Results: 74 patients consumed alcohol (median alcohol intake: 15 g/day); 68 reached viral eradication. During a median followup of 58 months, 33 patients developed HCC, 53 experienced at least one decompensation event, and 39 died. The 5-year cumulative incidence rate of HCC was 10.6% (95% CI: 4.6–16.6) in abstainers vs. 23.8% (95% CI: 13.5–34.1) in consumers (p = 0.087), and 2.0% (95% CI: 0–5.8) vs. 21.7% (95% CI: 14.2–29.2) in patients with and without viral eradication (p = 0.002), respectively. The lowest risk of HCC was observed for patients without alcohol intake and with viral eradication (0%) followed by patients with alcohol intake and viral eradication (6.2% [95% CI: 0–18.4]), patients without alcohol intake and no viral eradication (15.9% [95% CI: 7.1– 24.7]), and patients with alcohol intake and no viral eradication (29.2% [95% CI: 16.5–41.9]) (p = 0.009). In multivariate analysis, lack of viral eradication and alcohol consumption were associated with the risk of HCC (hazard ratio for alcohol consumption: 3.43, 95% CI: 1.49–7.92, p = 0.004). Alcohol intake did not influence the risk of decompensation or death. Conclusions: Light-to-moderate alcohol intake increases the risk of HCC in patients with HCV-related cirrhosis. Patient care should include measures to ensure abstinence. Lay summary:Whether alcohol intake increases the risk of complications in patients with HCV-related cirrhosis remains unclear. In this prospective study, light-to-moderate alcohol intake was associated with the risk of hepatocellular carcinoma in multivariate analysis. No patients who did not use alcohol and who reached viral eradication developed hepatocellular carcinoma during follow-up. The risk of hepatocellular carcinoma increased with alcohol intake or in patients without viral eradication and was highest when alcohol intake was present in the absence of viral eradication. Patients with HCV-related cirrhosis should be strongly advised against any alcohol intake. Patient care should include measures to ensure abstinence.

Disciplines :

Gastroenterology & hepatology

Author, co-author :

Vandenbulcke, H

Moreno, C

Colle, I

Knebel, JF

Francque, S

Sersté, T

George, C

de Galocsy, C

Laleman, W

DELWAIDE, Jean ; Centre Hospitalier Universitaire de Liège - CHU > Service de gastroentérologie, hépatologie, onco. digestive

More authors (11 more)

Language :

English

Title :

Alcohol intake increases the risk of HCC in hepatitis C virus-related cirrhosis: a prospective study.

Publication date :

2016

Journal title :

Journal of Hepatology

ISSN :

0168-8278

eISSN :

1600-0641

Publisher :

Elsevier, Oxford, United Kingdom

Volume :

Pages :

543-551

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 04 October 2016

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