Recompensation in Cirrhosis: Current Evidence and Future Directions

Sharma, Sanchit; Roy, Akash

doi:10.1016/j.jceh.2022.08.002

Cited by 7 publications

(4 citation statements)

References 20 publications

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“… 7 However, despite the utility of the latest Baveno VII criteria in identifying recompensation patients, little is known about the long-term outcomes of such patients. 10 A recent study from Hong Kong found that decompensated cirrhosis was associated with a higher risk of transplant-free survival compared to compensated cirrhosis, but there was no statistically significant difference in transplant-free survival between the recompensated and compensated groups in patients with HBV-related cirrhosis. 8 Another study investigated the survival rate in patients with decompensated alcohol-associated cirrhosis after recompensation.…”

Section: Discussionmentioning

confidence: 98%

Risk of HCC decreases in HBV-related patients with cirrhosis acquired recompensation: A retrospective study based on Baveno VII criteria

Zhang,

Liu,

et al. 2023

Hepatology Communications

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Background: Antiviral therapy improves the clinical outcomes of patients with HBV-related cirrhosis. In this study, we aimed to evaluate the incidence rate of HCC in patients with HBV-related recompensated, compensated, or decompensated cirrhosis based on the latest Baveno VII criteria. Methods: In this two-center retrospective study, HBV-related patients with cirrhosis were enrolled and treated with first-line nucleos(t)ide analogues therapy for at least 12 months. Participants were classified into 3 groups: (1) compensated group, (2) decompensated group, or (3) recompensated group according to Baveno VII criteria. Multivariate regression models and propensity score matching were used to identify the predictors of HCC. Results: Of the 404 patients recruited, during a median follow-up of 44.5 months (interquartile range 26.8, 57.0 months), 233 (57.7%), 100 (24.8%), and 71(17.6%) patients had compensated, recompensated, and decompensated cirrhosis. In total, 38 developed HCC. The cumulative incidence of HCC development at 2, 4, and 6 years was 1.3%, 5.4%, and 20.0% in the compensated group, 1.2%, 5.2%, and 24.5% in the recompensated group, and 2.1%, 23.6%, and 41.8% in the decompensated group, respectively. In the multivariate Cox regression model, compared with the recompensated group, the decompensated group had a significant increased risk for the development of HCC (aHR 2.55; 95% CI: 1.240–5.240; p = 0.027), while the compensated group had similar HCC risk for the development of HCC (aHR 1.41; 95% CI: 0.540–3.730; p = 0.835). Propensity score-matching analysis between the recompensated and compensated groups (84 pairs) and propensity score-matching analysis between the recompensated and decompensated groups (62 pairs) showed similar results. Conclusions: Achieving recompensation reduced the risk of HCC in patients with HBV-related decompensated cirrhosis, while the risk remained comparable to that of compensated cirrhosis.

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Section: Discussionmentioning

confidence: 98%

Risk of HCC decreases in HBV-related patients with cirrhosis acquired recompensation: A retrospective study based on Baveno VII criteria

Zhang,

Liu,

et al. 2023

Hepatology Communications

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“…It can eventually lead to liver fibrosis and cirrhosis. In most cases of acute injuries, with the disappearance of the causative agent, the liver will find its normal function and structure and no trace of damage will remain [44]. It is very important to accurately estimate the amount of liver fibrosis in the evaluation of prognosis, surveillance, and the adoption of therapeutic measures in chronic liver disease.…”

Section: Discussionmentioning

confidence: 99%

Nicotine promotes development of bile duct ligationinduced liver fibrosis by increasing expression of nicotinic acetylcholine receptors in rats

Hajiasgharzadeh,

Shahabi,

Karimi-Sales

et al. 2024

ceh

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Aim of the study: Liver fibrosis and cigarette smoking seem to be directly linked. Nicotine, as an agonist of nicotinic acetylcholine receptors (nAChRs), induces many downstream signaling pathways. The pathways through which nicotine affects the process of liver fibrosis have not been clarified. The present study aimed to investigate the nicotine-induced effects on fibrosis progression in cholestatic rats. Material and methods: First, the Wistar rats were subjected to sham or bile duct ligation (BDL) surgery. The rats were treated with low and high doses of nicotine (1 or 10 mg/kg) for three weeks. They were monitored for their body weights before and 21 days after BDL. Also, spleens were weighed to calculate the spleen/body weight ratio. Ductular proliferation and fibrosis were evaluated using hematoxylin and eosin (H&E) as well as Masson's trichrome staining. The mRNA expression of α4nAChR, α7nAChR, and fibrosis gene α-smooth muscle actin (α-SMA) was measured by real-time PCR. Results: The findings showed that nicotine promotes the development of BDL-induced liver fibrosis. The ratio of spleen/body weight was significantly affected by nicotine exposure. H&E and Masson's trichrome staining showed that the level of liver fibrosis was higher in the cholestatic BDL groups, and this effect was significantly augmented in the nicotine-treated rats. Also, α4nAChR, α7nAChR, and α-SMA expression was observed in the BDL rats and increased following nicotine treatment. Conclusions: The activation of nAChR triggers biliary proliferation and liver fibrosis. Studying the intracellular mechanism of nicotine and alteration in the expression of nicotinic receptors following nicotine exposure can be useful both in diagnosing nicotine-related diseases and finding new treatment strategies.

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“…This also highlights the need for further studies investigating the pathophysiology of sex-based differences in the burden of cirrhosis, including potential variations in genotype and gut microbiome which have been shown to affect disease progression in cirrhosis [ 36 , 48 , 49 ]. Further insight into sex-based differences in the natural history of cirrhosis is also required, with recent evidence based on analysis of transplant registries suggesting that disease regression and recompensation are possible, although data on sex-based differences remain limited [ 50 ].…”

Section: Discussionmentioning

confidence: 99%

Global Epidemiology of Cirrhosis: Changing Etiological Basis and Comparable Burden of Nonalcoholic Steatohepatitis between Males and Females

Tan,

Chan,

Wong

et al. 2023

Dig Dis

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Introduction: The etiology of liver diseases has changed significantly, but its impact on the comparative burden of cirrhosis between males and females is unclear. We estimated sex differences in the burden of cirrhosis across 204 countries and territories from 2010 to 2019. Methods: We analyzed temporal trends in the burden of cirrhosis using the methodology framework of the 2019 Global Burden of Disease study. We estimated annual frequencies and age-standardized rates (ASRs) of cirrhosis incidence, death, and disability-adjusted life-years (DALYs) by sex, region, country, and etiology. Results: In 2019, the frequency of incident cases, deaths, and DALYs due to cirrhosis was 1,206,125, 969,068, and 31,781,079 in males versus 845,429, 502,944, and 14,408,336 in females, respectively. From 2010 to 2019, the frequency of cirrhosis deaths increased by 9% in males and 12% in females. Incidence ASRs remained stable in males but increased in females, while death ASRs declined in both. Death ASRs for both sexes declined in all regions, except in the Americas where they remained stable. In 2019, alcohol was the leading cause of cirrhosis deaths in males, and hepatitis C in females. Death ASRs declined for all etiologies in both sexes, except in nonalcoholic steatohepatitis (NASH). The ratio of female-to-male incidence ASRs in 2019 was lowest in alcohol(0.5), and highest in NASH(1.3), while the ratio of female-to-male death ASRs was lowest in alcohol(0.3) and highest in NASH(0.8). Conclusion: The global burden of cirrhosis is higher in males. However, incidence and death ASRs from NASH cirrhosis in females are comparable to that of males.

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Recompensation in Cirrhosis: Current Evidence and Future Directions

Cited by 7 publications

References 20 publications

Risk of HCC decreases in HBV-related patients with cirrhosis acquired recompensation: A retrospective study based on Baveno VII criteria

Risk of HCC decreases in HBV-related patients with cirrhosis acquired recompensation: A retrospective study based on Baveno VII criteria

Nicotine promotes development of bile duct ligationinduced liver fibrosis by increasing expression of nicotinic acetylcholine receptors in rats

Global Epidemiology of Cirrhosis: Changing Etiological Basis and Comparable Burden of Nonalcoholic Steatohepatitis between Males and Females

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