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

Abstract

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.

Effects of endoscopic injection sclerotherapy for esophagogastric varices on portal hemodynamics and liver function

“…Therefore, changes in portal hemodynamics following EIS did not affect EGV recurrence in those with Child-Pugh A or B-LC. Alcohol drinking were identified as independent predictors of EGV recurrence and other report also supports our results [25]. On the other hand, although EIS can lead to the short-term (one year) improvement of liver function, the effect cannot lead to affecting the prognosis and the recurrence of EGV for a long term (5 years).…”

A Meta-Analysis of How Nonalcoholic Fatty Liver Disease Affect Antiviral Treatment of Patients with e Antigen-Positive Chronic Hepatitis B

“…In Western countries, the prevalence of NAFLD in the general population is about 30%, and the prevalence is even higher in obesity. The prevalence of NAFLD has been reported to affect 80–100 million people in the United States, of which 10–22% may develop NASH [ 6 , 7 ]. The prevalence of NAFLD is increasing especially in Asian countries such as China and Japan, and the age is getting younger.…”

Epidemiology of liver cirrhosis and associated complications: Current knowledge and future directions

“…However, the prognosis for HCC due to alcoholic cirrhosis appears to be worse[ 130 ]. Furthermore, alcohol consumption increases the incidence of HCC in HBV-related cirrhosis[ 131 - 133 ], while abstinence from alcohol significantly reduces the risk of developing HCC[ 133 ].…”

“…NAFLD and ALD-related cirrhosis will account for almost all newly diagnosed cases in Canada by 2040[ 158 ]. Alcohol intake can influence cirrhosis of any etiology[ 133 , 159 - 161 ]. Therefore, effective measures to prevent and reduce the associated contributing factors will likely help mitigate the epidemic.…”