Effect of Hepatitis C Virus Infection and Abstinence From Alcohol on Survival in Patients With Alcoholic Cirrhosis
Effect of Hepatitis C Virus Infection and Abstinence From Alcohol on Survival in Patients With Alcoholic Cirrhosis
复制标题
丙型肝炎病毒感染和戒酒对酒精性肝硬化患者生存的影响
DOI：
10.1097/00004836-200302000-00016
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发表时间：
2003
影响因子：
2.9
通讯作者：
J. Rodrigo
中科院分区：
文献类型：
--
作者：
M. Serra;A. Escudero;Felicidad Rodríguez;J. D. Del Olmo;J. Rodrigo
目的：我们评估HCV感染和戒酒对酒精性肝硬化患者生存率的影响。背景丙型肝炎病毒（HCV）感染可能是慢性酒精中毒者肝脏疾病的重要辅助因素。研究研究人群包括213例诊断为酒精性肝硬化的患者，其中72例患者感染HCV。86例酒精性肝硬化患者在诊断后完全戒酒。对照组包括89例抗-HCV阳性且从未饮酒的患者。采用Kaplan和Meier方法分析生存率，采用考克斯多元回归模型分析生存率预测因子。结果HCV感染不是酒精性肝硬化患者生存的决定性因素。诊断肝硬化时的年龄和Child-Pugh分级以及诊断后持续饮酒是预后不良的独立预测因素。戒酒酗酒者的累积生存曲线与保持相同饮酒模式的酗酒者的累积生存曲线显著不同（对数秩= 4.30，p = 0.0381）。此外，诊断后停止饮酒的抗HCV阳性肝硬化患者的累积生存率与从未饮酒的HCV阳性肝硬化患者相似（对数秩0.26，p = 0.61）。结论酒精性肝硬化的累积生存率似乎不受HCV感染标志物存在与否的影响。一旦酒精中毒患者被诊断为肝硬化，强烈建议完全戒酒。
Goals We assessed the effect of HCV infection and abstinence from alcohol on survival in a cohort of patients with alcoholic cirrhosis. Background Hepatitis C virus (HCV) infection may be an important cofactor for liver disease in chronic alcoholics. Study The study population consisted of 213 patients with the diagnosis of alcoholic cirrhosis, 72 of these patients were infected by HCV. Complete alcohol abstinence after diagnosis of alcoholic cirrhosis was recorded in 86 patients. The reference group consisted of 89 patients with anti-HCV positivity who had never consumed alcohol. Survival was analyzed by the Kaplan and Meier method and predictors of survival by the Cox's multiple regression model. Results HCV infection was not a determinant factor for survival in alcoholic cirrhosis. Age and Child-Pugh grade at the time of diagnosis of cirrhosis and persistence of alcohol consumption after diagnosis were independent predictors of poor outcome. The cumulative survival curve in abstinent alcoholics was significantly different from that of alcoholics who maintained the same pattern of alcohol consumption (log-rank = 4.30, p = 0.0381). Moreover, the cumulative survival in patients with anti-HCV–positive cirrhosis who stopped drinking after diagnosis was similar to that in patients with HCV-positive cirrhosis who had never consumed alcohol (log-rank 0.26, p = 0.61). Conclusions Cumulative survival in alcoholic cirrhosis does not seem to be influenced by the presence or absence of markers of HCV infection. Once liver cirrhosis has been diagnosed in the alcoholic patient, complete alcohol abstinence should be strongly recommended.