Abstract :
[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.
Scopus citations®
without self-citations
70