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Recurrent alcohol-associated hepatitis is common and is associated with increased mortality.
Gratacós-Ginès, Jordi; Ruz-Zafra, Pilar; Celada-Sendino, Miriam; Martí-Carretero, Aina; Pujol, Clàudia; Martín-Mateos, Rosa; Echavarría, Víctor; Frisancho, Luis E; García, Sonia; Barreales, Mónica; Tejedor-Tejada, Javier; Vázquez-Rodríguez, Sergio; Cañete, Nuria; Fernández-Carrillo, Carlos; Valenzuela, María; Martí-Aguado, David; Horta, Diana; Quiñones, Marta; Bernal-Monterde, Vanesa; Acosta, Silvia; Artaza, Tomás; Pinazo, José; Villar-Lucas, Carmen; Clemente-Sánchez, Ana; Badia-Aranda, Ester; Giráldez-Gallego, Álvaro; Rodríguez, Manuel; Sancho-Bru, Pau; Cabezas, Joaquín; Ventura-Cots, Meritxell; Fernández-Rodríguez, Conrado; Aguilera, Victoria; Tomé, Santiago; Bataller, Ramon; Caballería, Juan; Pose, Elisa.
Afiliación
  • Gratacós-Ginès J; Department of Liver Diseases, Hospital Clínic de Barcelona, Barcelona, Spain.
  • Ruz-Zafra P; Liver, Digestive System and Metabolism Department Institut d'Investigacions Biomèdiques August Pi i Sunyer, IDIBAPS, Barcelona, Spain.
  • Celada-Sendino M; Department of Liver Injury, Progression of Cirrhosis and Liver Transplantation, Centro de Investigación Biomédica En Red de Enfermedades Hepáticas y Digestivas, CIBERehd, Madrid, Spain.
  • Martí-Carretero A; Department of Digestive Diseases, Hospital Universitario Virgen del Rocío, Sevilla, Spain.
  • Pujol C; Department of Liver Diseases, Hospital Universitario Central de Asturias, ISPA, Oviedo, Spain.
  • Martín-Mateos R; Department of Liver Diseases, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institute of Research, Universitat Autònoma de Barcelona, Barcelona, Spain.
  • Echavarría V; Department of Gastroenterology, Hospital Santa Creu i Sant Pau, Barcelona, Spain.
  • Frisancho LE; Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, Madrid, Spain.
  • García S; Department of Gastroenterology and Hepatology, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
  • Barreales M; Department of Liver Diseases, Hospital Parc Taulí, Sabadell, Spain.
  • Tejedor-Tejada J; Department of Hepatology and Liver Transplant, Hospital Universitari i Politècnic La Fe, IISLa FE, Valencia, Spain.
  • Vázquez-Rodríguez S; Department of Liver Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain.
  • Cañete N; Department of Gastroenterology, Hospital Universitario de Cabueñes, Gijón, Spain.
  • Fernández-Carrillo C; Department of Gastroenterology. Xerencia Xestion Integrada de Vigo Research Group in Digestive Diseases, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, SERGAS, Vigo, Spain.
  • Valenzuela M; Liver Section, Department of Gastroenterology, Hospital del Mar, Barcelona, Spain.
  • Martí-Aguado D; Department of Gastroenterology and Hepatology, Hospital Universitario Puerta de Hierro, Madrid, Spain.
  • Horta D; Department of Gastroenterology and Hepatology, Hospital Universitari Dr. Josep Trueta, Girona, Spain.
  • Quiñones M; Digestive Disease Department, Clínic University Hospital, Biomedical Research Institute INCLIVA, Valencia, Spain.
  • Bernal-Monterde V; Department of Digestive Diseases, Hospital Universitari Mútua Terrassa, Terrassa, Spain.
  • Acosta S; Gastroenterology Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain.
  • Artaza T; Department of Digestive Diseases, Hospital Universitario Miguel Servet, Zaragoza, Spain.
  • Pinazo J; Department of Digestive Diseases, Hospital Universitario Nuestra Señora de Candelaria, Tenerife, Spain.
  • Villar-Lucas C; Department of Digestive Diseases, Hospital Universitario de Toledo, Toledo, Spain.
  • Clemente-Sánchez A; Department of Gastroenterology, Hospital Virgen de la Victoria, Málaga, Spain.
  • Badia-Aranda E; Department of Digestive Diseases, Hospital Universitario de Salamanca, Salamanca, Spain.
  • Giráldez-Gallego Á; Department of Liver Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
  • Rodríguez M; Department of Digestive Diseases, Hospital Universitario de Burgos, Burgos, Spain.
  • Sancho-Bru P; Department of Digestive Diseases, Hospital Universitario Virgen del Rocío, Sevilla, Spain.
  • Cabezas J; Department of Liver Diseases, Hospital Universitario Central de Asturias, ISPA, Oviedo, Spain.
  • Ventura-Cots M; Liver, Digestive System and Metabolism Department Institut d'Investigacions Biomèdiques August Pi i Sunyer, IDIBAPS, Barcelona, Spain.
  • Fernández-Rodríguez C; Department of Gastroenterology and Hepatology, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
  • Aguilera V; Department of Liver Injury, Progression of Cirrhosis and Liver Transplantation, Centro de Investigación Biomédica En Red de Enfermedades Hepáticas y Digestivas, CIBERehd, Madrid, Spain.
  • Tomé S; Department of Liver Diseases, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institute of Research, Universitat Autònoma de Barcelona, Barcelona, Spain.
  • Bataller R; Gastroenterology Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain.
  • Caballería J; Department of Medicine, Universidad Rey Juan Carlos, Madrid, Spain.
  • Pose E; Department of Liver Injury, Progression of Cirrhosis and Liver Transplantation, Centro de Investigación Biomédica En Red de Enfermedades Hepáticas y Digestivas, CIBERehd, Madrid, Spain.
Hepatology ; 80(3): 621-632, 2024 09 01.
Article en En | MEDLINE | ID: mdl-38441908
ABSTRACT
BACKGROUND AND

AIMS:

Alcohol relapse after surviving an episode of alcohol-associated hepatitis (AH) is common. However, the clinical features, risk factors, and prognostic implications of recurrent alcohol-associated hepatitis (RAH) are not well described. APPROACH AND

RESULTS:

A registry-based study was done of patients admitted to 28 Spanish hospitals for an episode of AH between 2014 and 2021. Baseline demographics and laboratory variables were collected. Risk factors for RAH were investigated using Cox regression analysis. We analyzed the severity of the index episodes of AH and compared it to that of RAH. Long-term survival was assessed by Kaplan-Meier curves and log-rank tests. A total of 1118 patients were included in the analysis, 125 (11%) of whom developed RAH during follow-up (median 17 [7-36] months). The incidence of RAH in patients resuming alcohol use was 22%. The median time to recurrence was 14 (8-29) months. Patients with RAH had more psychiatric comorbidities. Risk factors for developing RAH included age <50 years, alcohol use >10 U/d, and history of liver decompensation. RAH was clinically more severe compared to the first AH (higher MELD, more frequent ACLF, and HE). Moreover, alcohol abstinence during follow-up was less common after RAH (18% vs. 45%, p <0.001). Most importantly, long-term mortality was higher in patients who developed RAH (39% vs. 21%, p = 0.026), and presenting with RAH independently predicted high mortality (HR 1.55 [1.11-2.18]).

CONCLUSIONS:

RAH is common and has a more aggressive clinical course, including increased mortality. Patients surviving an episode of AH should undergo intense alcohol use disorder therapy to prevent RAH.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Recurrencia / Sistema de Registros / Hepatitis Alcohólica Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Hepatology Año: 2024 Tipo del documento: Article País de afiliación: España Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Recurrencia / Sistema de Registros / Hepatitis Alcohólica Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Hepatology Año: 2024 Tipo del documento: Article País de afiliación: España Pais de publicación: Estados Unidos