The natural history of compensated HCV-related cirrhosis: A prospective long-term study
Background & Aims The natural history of HCV-related compensated cirrhosis has been poorly investigated in Latin-American countries. Our study evaluated mortality and clinical outcomes in compensated cirrhotic patients followed for 6 years. Methods Four hundred and two patients with compensated...
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| Veröffentlicht in: | Journal of hepatology 2013-03, Vol.58 (3), p.434-444 |
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| creator | Gomez, Eduardo Vilar Rodriguez, Yoan Sanchez Bertot, Luis Calzadilla Gonzalez, Ana Torres Perez, Yadina Martinez Soler, Enrique Arus Garcia, Ali Yasells Blanco, Luis Perez |
| description | Background & Aims The natural history of HCV-related compensated cirrhosis has been poorly investigated in Latin-American countries. Our study evaluated mortality and clinical outcomes in compensated cirrhotic patients followed for 6 years. Methods Four hundred and two patients with compensated HCV-related cirrhosis were prospectively recruited in a tertiary care academic center. At the time of admission, patients were stratified as compensated (absence [stage 1] or presence [stage 2] of esophageal varices) as defined by D’Amico et al . Subjects were followed to identify overall mortality or liver transplantation and clinical complication rates. Results Among 402 subjects, 294 were categorized as stage 1 and 108 as stage 2. Over a median of 176 weeks, 42 deaths occurred (10%), of which 30 were considered liver-related (7%) and 12 non-liver-related (3%); eight individuals (2%) underwent liver transplantation; 30 patients (7%) developed HCC, 67 individuals in stage 1 (22%) developed varices and any event of clinical decompensation occurred in 80 patients (20%). The 6-year cumulative overall mortality or liver transplantation was 15% and 45%, for stages 1 and 2, respectively ( p |
| doi_str_mv | 10.1016/j.jhep.2012.10.023 |
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Our study evaluated mortality and clinical outcomes in compensated cirrhotic patients followed for 6 years. Methods Four hundred and two patients with compensated HCV-related cirrhosis were prospectively recruited in a tertiary care academic center. At the time of admission, patients were stratified as compensated (absence [stage 1] or presence [stage 2] of esophageal varices) as defined by D’Amico et al . Subjects were followed to identify overall mortality or liver transplantation and clinical complication rates. Results Among 402 subjects, 294 were categorized as stage 1 and 108 as stage 2. Over a median of 176 weeks, 42 deaths occurred (10%), of which 30 were considered liver-related (7%) and 12 non-liver-related (3%); eight individuals (2%) underwent liver transplantation; 30 patients (7%) developed HCC, 67 individuals in stage 1 (22%) developed varices and any event of clinical decompensation occurred in 80 patients (20%). The 6-year cumulative overall mortality or liver transplantation was 15% and 45%, for stages 1 and 2, respectively ( p <0.001). The cumulative 6-year HCC incidence was significantly higher among patients with varices (29%) than those without varices (9%), p <0.001. Similarly, the cumulative 6-year incidence of any clinical liver-related complication was higher in patients with stage 2 (66%) as compared to 26% in those with stage 1, respectively ( p <0.001). Conclusions Our results indicate significant morbidity and mortality and clinical outcome rates in compensated cirrhotic patients with varices (stage 2).</description><identifier>ISSN: 0168-8278</identifier><identifier>EISSN: 1600-0641</identifier><identifier>DOI: 10.1016/j.jhep.2012.10.023</identifier><identifier>PMID: 23111008</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Aged ; Antiviral Agents - therapeutic use ; Carcinoma, Hepatocellular - epidemiology ; Child-Pugh score ; Clinical decompensation ; Development of varices ; Female ; Gastroenterology and Hepatology ; HCV-related cirrhosis ; Hepatitis C - complications ; Hepatitis C - drug therapy ; Hepatocellular carcinoma ; Humans ; Incidence ; Liver Cirrhosis - etiology ; Liver Cirrhosis - mortality ; Liver Neoplasms - epidemiology ; Liver Transplantation ; Longitudinal Studies ; Male ; MELD score ; Middle Aged ; Mortality ; Prospective Studies ; Varicose Veins - epidemiology</subject><ispartof>Journal of hepatology, 2013-03, Vol.58 (3), p.434-444</ispartof><rights>European Association for the Study of the Liver</rights><rights>2012 European Association for the Study of the Liver</rights><rights>Copyright © 2012 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c477t-355eea66edb8dc3c18c8c7a5aa76467229b5a223516108f50b9e9370bd4a58e73</citedby><cites>FETCH-LOGICAL-c477t-355eea66edb8dc3c18c8c7a5aa76467229b5a223516108f50b9e9370bd4a58e73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0168827812008227$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23111008$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gomez, Eduardo Vilar</creatorcontrib><creatorcontrib>Rodriguez, Yoan Sanchez</creatorcontrib><creatorcontrib>Bertot, Luis Calzadilla</creatorcontrib><creatorcontrib>Gonzalez, Ana Torres</creatorcontrib><creatorcontrib>Perez, Yadina Martinez</creatorcontrib><creatorcontrib>Soler, Enrique Arus</creatorcontrib><creatorcontrib>Garcia, Ali Yasells</creatorcontrib><creatorcontrib>Blanco, Luis Perez</creatorcontrib><title>The natural history of compensated HCV-related cirrhosis: A prospective long-term study</title><title>Journal of hepatology</title><addtitle>J Hepatol</addtitle><description>Background & Aims The natural history of HCV-related compensated cirrhosis has been poorly investigated in Latin-American countries. Our study evaluated mortality and clinical outcomes in compensated cirrhotic patients followed for 6 years. Methods Four hundred and two patients with compensated HCV-related cirrhosis were prospectively recruited in a tertiary care academic center. At the time of admission, patients were stratified as compensated (absence [stage 1] or presence [stage 2] of esophageal varices) as defined by D’Amico et al . Subjects were followed to identify overall mortality or liver transplantation and clinical complication rates. Results Among 402 subjects, 294 were categorized as stage 1 and 108 as stage 2. Over a median of 176 weeks, 42 deaths occurred (10%), of which 30 were considered liver-related (7%) and 12 non-liver-related (3%); eight individuals (2%) underwent liver transplantation; 30 patients (7%) developed HCC, 67 individuals in stage 1 (22%) developed varices and any event of clinical decompensation occurred in 80 patients (20%). The 6-year cumulative overall mortality or liver transplantation was 15% and 45%, for stages 1 and 2, respectively ( p <0.001). The cumulative 6-year HCC incidence was significantly higher among patients with varices (29%) than those without varices (9%), p <0.001. Similarly, the cumulative 6-year incidence of any clinical liver-related complication was higher in patients with stage 2 (66%) as compared to 26% in those with stage 1, respectively ( p <0.001). Conclusions Our results indicate significant morbidity and mortality and clinical outcome rates in compensated cirrhotic patients with varices (stage 2).</description><subject>Aged</subject><subject>Antiviral Agents - therapeutic use</subject><subject>Carcinoma, Hepatocellular - epidemiology</subject><subject>Child-Pugh score</subject><subject>Clinical decompensation</subject><subject>Development of varices</subject><subject>Female</subject><subject>Gastroenterology and Hepatology</subject><subject>HCV-related cirrhosis</subject><subject>Hepatitis C - complications</subject><subject>Hepatitis C - drug therapy</subject><subject>Hepatocellular carcinoma</subject><subject>Humans</subject><subject>Incidence</subject><subject>Liver Cirrhosis - etiology</subject><subject>Liver Cirrhosis - mortality</subject><subject>Liver Neoplasms - epidemiology</subject><subject>Liver Transplantation</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>MELD score</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Prospective Studies</subject><subject>Varicose Veins - epidemiology</subject><issn>0168-8278</issn><issn>1600-0641</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kUFv1DAQhS0EokvhD3BAPnLJMrYT20EIqVoBRarUQ0t7tBxnlnVI4mAnlfbf47CFAwdOY43eezP-hpDXDLYMmHzXbbsDTlsOjOfGFrh4QjZMAhQgS_aUbLJIF5orfUZepNQBgIC6fE7OuGCMAegNub89IB3tvETb04NPc4hHGvbUhWHCMdkZW3q5uysi9r_fzsd4CMmn9_SCTjGkCd3sH5D2YfxezBgHmualPb4kz_a2T_jqsZ6Tb58_3e4ui6vrL193F1eFK5WaC1FViFZKbBvdOuGYdtopW1mrZCkV53VTWc5FxSQDva-gqbEWCpq2tJVGJc7J21Nu3uXngmk2g08O-96OGJZkGNd1qaSQVZbyk9TltVPEvZmiH2w8GgZmBWo6swI1K9C1l4Fm05vH_KUZsP1r-UMwCz6cBJh_-eAxmuQ8jg5bHzMa0wb___yP_9hd70fvbP8Dj5i6sMQx8zPMJG7A3KwnXS_KeB7OuRK_AJVym5c</recordid><startdate>20130301</startdate><enddate>20130301</enddate><creator>Gomez, Eduardo Vilar</creator><creator>Rodriguez, Yoan Sanchez</creator><creator>Bertot, Luis Calzadilla</creator><creator>Gonzalez, Ana Torres</creator><creator>Perez, Yadina Martinez</creator><creator>Soler, Enrique Arus</creator><creator>Garcia, Ali Yasells</creator><creator>Blanco, Luis Perez</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20130301</creationdate><title>The natural history of compensated HCV-related cirrhosis: A prospective long-term study</title><author>Gomez, Eduardo Vilar ; Rodriguez, Yoan Sanchez ; Bertot, Luis Calzadilla ; Gonzalez, Ana Torres ; Perez, Yadina Martinez ; Soler, Enrique Arus ; Garcia, Ali Yasells ; Blanco, Luis Perez</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c477t-355eea66edb8dc3c18c8c7a5aa76467229b5a223516108f50b9e9370bd4a58e73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aged</topic><topic>Antiviral Agents - therapeutic use</topic><topic>Carcinoma, Hepatocellular - epidemiology</topic><topic>Child-Pugh score</topic><topic>Clinical decompensation</topic><topic>Development of varices</topic><topic>Female</topic><topic>Gastroenterology and Hepatology</topic><topic>HCV-related cirrhosis</topic><topic>Hepatitis C - complications</topic><topic>Hepatitis C - drug therapy</topic><topic>Hepatocellular carcinoma</topic><topic>Humans</topic><topic>Incidence</topic><topic>Liver Cirrhosis - etiology</topic><topic>Liver Cirrhosis - mortality</topic><topic>Liver Neoplasms - epidemiology</topic><topic>Liver Transplantation</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>MELD score</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Prospective Studies</topic><topic>Varicose Veins - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gomez, Eduardo Vilar</creatorcontrib><creatorcontrib>Rodriguez, Yoan Sanchez</creatorcontrib><creatorcontrib>Bertot, Luis Calzadilla</creatorcontrib><creatorcontrib>Gonzalez, Ana Torres</creatorcontrib><creatorcontrib>Perez, Yadina Martinez</creatorcontrib><creatorcontrib>Soler, Enrique Arus</creatorcontrib><creatorcontrib>Garcia, Ali Yasells</creatorcontrib><creatorcontrib>Blanco, Luis Perez</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of hepatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gomez, Eduardo Vilar</au><au>Rodriguez, Yoan Sanchez</au><au>Bertot, Luis Calzadilla</au><au>Gonzalez, Ana Torres</au><au>Perez, Yadina Martinez</au><au>Soler, Enrique Arus</au><au>Garcia, Ali Yasells</au><au>Blanco, Luis Perez</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The natural history of compensated HCV-related cirrhosis: A prospective long-term study</atitle><jtitle>Journal of hepatology</jtitle><addtitle>J Hepatol</addtitle><date>2013-03-01</date><risdate>2013</risdate><volume>58</volume><issue>3</issue><spage>434</spage><epage>444</epage><pages>434-444</pages><issn>0168-8278</issn><eissn>1600-0641</eissn><abstract>Background & Aims The natural history of HCV-related compensated cirrhosis has been poorly investigated in Latin-American countries. Our study evaluated mortality and clinical outcomes in compensated cirrhotic patients followed for 6 years. Methods Four hundred and two patients with compensated HCV-related cirrhosis were prospectively recruited in a tertiary care academic center. At the time of admission, patients were stratified as compensated (absence [stage 1] or presence [stage 2] of esophageal varices) as defined by D’Amico et al . Subjects were followed to identify overall mortality or liver transplantation and clinical complication rates. Results Among 402 subjects, 294 were categorized as stage 1 and 108 as stage 2. Over a median of 176 weeks, 42 deaths occurred (10%), of which 30 were considered liver-related (7%) and 12 non-liver-related (3%); eight individuals (2%) underwent liver transplantation; 30 patients (7%) developed HCC, 67 individuals in stage 1 (22%) developed varices and any event of clinical decompensation occurred in 80 patients (20%). The 6-year cumulative overall mortality or liver transplantation was 15% and 45%, for stages 1 and 2, respectively ( p <0.001). The cumulative 6-year HCC incidence was significantly higher among patients with varices (29%) than those without varices (9%), p <0.001. Similarly, the cumulative 6-year incidence of any clinical liver-related complication was higher in patients with stage 2 (66%) as compared to 26% in those with stage 1, respectively ( p <0.001). Conclusions Our results indicate significant morbidity and mortality and clinical outcome rates in compensated cirrhotic patients with varices (stage 2).</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>23111008</pmid><doi>10.1016/j.jhep.2012.10.023</doi><tpages>11</tpages></addata></record> |
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| subjects | Aged Antiviral Agents - therapeutic use Carcinoma, Hepatocellular - epidemiology Child-Pugh score Clinical decompensation Development of varices Female Gastroenterology and Hepatology HCV-related cirrhosis Hepatitis C - complications Hepatitis C - drug therapy Hepatocellular carcinoma Humans Incidence Liver Cirrhosis - etiology Liver Cirrhosis - mortality Liver Neoplasms - epidemiology Liver Transplantation Longitudinal Studies Male MELD score Middle Aged Mortality Prospective Studies Varicose Veins - epidemiology |
| title | The natural history of compensated HCV-related cirrhosis: A prospective long-term study |
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