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Clinical features and outcomes of cirrhosis due to non-alcoholic steatohepatitis compared with cirrhosis caused by chronic hepatitis C
- Source :
- Journal of Gastroenterology and Hepatology. 24:248-254
- Publication Year :
- 2009
- Publisher :
- Wiley, 2009.
-
Abstract
- Background and Aim: Ethnic differences in non-alcoholic steatohepatitis (NASH) are well-documented, but there has been no study on the prognosis of Japanese NASH patients with cirrhosis. Accordingly, we compared cirrhotic NASH with liver cirrhosis caused by chronic hepatitis C (LC-C) to clarify its clinical features and define the risk factors for death. Methods: A prospective evaluation of the outcomes of NASH patients with severe fibrosis was started in 1990. Data on age- and sex-matched patients with biopsy-proven LC-C were collected retrospectively and used as the control. Results: There were 68 patients with cirrhotic NASH and 69 with LC-C. The Child–Turcotte–Pugh (CTP) class was similar in these two groups. Although the outcome of the NASH group was better than that of the LC-C group, cirrhotic NASH followed a similar course to that of LC-C; that is, complications of cirrhosis developed, including hepatocellular carcinoma (HCC; the 5-year HCC rate was 11.3% for NASH and 30.5% for HCV) and death (the 5-year survival rates were 75.2% and 73.8%, respectively). HCC was the leading cause of death in both groups (NASH, 47%; HCV, 68%). The occurrence of HCC and the CTP class were significant risk factors for mortality in NASH patients according to a multivariate analysis (HCC: hazard ratio [HR] 7.96, 95% confidence interval [CI] 2.45–25.88, CTP class A: HR 0.17, 95% CI 0.06–0.50). Conclusion: In conclusion, the present study confirmed that cirrhotic NASH has a similar course to LC-C. The occurrence of HCC was the strongest predictor of mortality in the NASH groups. These findings may be helpful when deciding on therapeutic interventions for NASH and also for the daily management of these patients.
- Subjects :
- Adult
Liver Cirrhosis
Male
medicine.medical_specialty
Carcinoma, Hepatocellular
Time Factors
Cirrhosis
Adolescent
Biopsy
Kaplan-Meier Estimate
Risk Assessment
Severity of Illness Index
digestive system
Gastroenterology
Young Adult
Asian People
Japan
Risk Factors
Internal medicine
medicine
Humans
Prospective Studies
Prospective cohort study
Aged
Proportional Hazards Models
Retrospective Studies
Cause of death
Aged, 80 and over
Hepatology
business.industry
Liver Neoplasms
Fatty liver
Hazard ratio
nutritional and metabolic diseases
Hepatitis C
Hepatitis C, Chronic
Middle Aged
medicine.disease
digestive system diseases
Fatty Liver
Treatment Outcome
Liver
Case-Control Studies
Hepatocellular carcinoma
Disease Progression
Female
Steatohepatitis
business
Subjects
Details
- ISSN :
- 14401746 and 08159319
- Volume :
- 24
- Database :
- OpenAIRE
- Journal :
- Journal of Gastroenterology and Hepatology
- Accession number :
- edsair.doi.dedup.....6a59b4a25b6da0ae74c67c148c81c442