title: Alcohol intake increases the risk of HCC in hepatitis C virus-related compensated cirrhosis: A prospective study.
abstract: Whether alcohol intake increases the risk of complications in patients with HCV-related cirrhosis remains unclear. The aim of this study was to determine the impact of alcohol intake and viral eradication on the risk of hepatocellular carcinoma (HCC), decompensation of cirrhosis and death.
  
  
  
  Data on alcohol intake and viral eradication were prospectively collected in 192 patients with compensated HCV-related cirrhosis.
  
  
  
  74 patients consumed alcohol (median alcohol intake: 15g/day); 68 reached viral eradication. During a median follow-up of 58months, 33 patients developed HCC, 53 experienced at least one decompensation event, and 39 died. The 5-year cumulative incidence rate of HCC was 10.6% (95% CI: 4.6-16.6) in abstainers vs. 23.8% (95% CI: 13.5-34.1) in consumers (p=0.087), and 2.0% (95% CI: 0-5.8) vs. 21.7% (95% CI: 14.2-29.2) in patients with and without viral eradication (p=0.002), respectively. The lowest risk of HCC was observed for patients without alcohol intake and with viral eradication (0%) followed by patients with alcohol intake and viral eradication (6.2% [95% CI: 0-18.4]), patients without alcohol intake and no viral eradication (15.9% [95% CI: 7.1-24.7]), and patients with alcohol intake and no viral eradication (29.2% [95% CI: 16.5-41.9]) (p=0.009). In multivariate analysis, lack of viral eradication and alcohol consumption were associated with the risk of HCC (hazard ratio for alcohol consumption: 3.43, 95% CI: 1.49-7.92, p=0.004). Alcohol intake did not influence the risk of decompensation or death.
  
  
  
  Light-to-moderate alcohol intake increases the risk of HCC in patients with HCV-related cirrhosis. Patient care should include measures to ensure abstinence.
  
  
  
  Whether alcohol intake increases the risk of complications in patients with HCV-related cirrhosis remains unclear. In this prospective study, light-to-moderate alcohol intake was associated with the risk of hepatocellular carcinoma in multivariate analysis. No patients who did not use alcohol and who reached viral eradication developed hepatocellular carcinoma during follow-up. The risk of hepatocellular carcinoma increased with alcohol intake or in patients without viral eradication and was highest when alcohol intake was present in the absence of viral eradication. Patients with HCV-related cirrhosis should be strongly advised against any alcohol intake. Patient care should include measures to ensure abstinence.
authors.affiliation: Departement of Gastroenterology and Hepatology, Hôpital de Jolimont, Haine-Saint-Paul, Belgium.
authors.forename: Hélène
authors.initials: H
authors.lastname: Vandenbulcke
authors.affiliation: Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, CUB Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Christophe
authors.initials: C
authors.lastname: Moreno
authors.affiliation: Departement of Gastroenterology and Hepatology, Ghent University Hospital, Ghent, Belgium.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Colle
authors.affiliation: Laboratory for Investigative Neurophysiology (The LINE), Department of Radiology and Department of Clinical Neurosciences, University Hospital Center and University of Lausanne, 1011 Lausanne, Switzerland; EEG Brain Mapping Core, Centre for Biomedical Imaging (CIBM), 1011 Lausanne, Switzerland.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Knebel
authors.affiliation: Departement of Gastroenterology and Hepatology, UZ Antwerpen, Edegem, Belgium.
authors.forename: Sven
authors.initials: S
authors.lastname: Francque
authors.affiliation: Departement of Gastroenterology and Hepatology, CHU Saint-Pierre, Brussels, Belgium.
authors.forename: Thomas
authors.initials: T
authors.lastname: Sersté
authors.affiliation: Departement of Gastroenterology and Hepatology, AZ Groeninge, Kortrijk, Belgium.
authors.forename: Christophe
authors.initials: C
authors.lastname: George
authors.affiliation: Departement of Gastroenterology and Hepatology, Hôpitaux Iris Sud Bracops, Brussels, Belgium.
authors.forename: Chantal
authors.initials: C
authors.lastname: de Galocsy
authors.affiliation: Departement of Gastroenterology and Hepatology, KUL, Leuven, Belgium.
authors.forename: Wim
authors.initials: W
authors.lastname: Laleman
authors.affiliation: Departement of Gastroenterology and Hepatology, CHU Liège, Liège, Belgium.
authors.forename: Jean
authors.initials: J
authors.lastname: Delwaide
authors.affiliation: Departement of Gastroenterology and Hepatology, AZ St Jan, Brugge, Belgium.
authors.forename: Hans
authors.initials: H
authors.lastname: Orlent
authors.affiliation: Departement of Gastroenterology and Hepatology, CHU Brugmann, Brussels, Belgium.
authors.forename: Luc
authors.initials: L
authors.lastname: Lasser
authors.affiliation: Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, CUB Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Eric
authors.initials: E
authors.lastname: Trépo
authors.affiliation: Departement of Gastroenterology and Hepatology, Ghent University Hospital, Ghent, Belgium.
authors.forename: Hans
authors.initials: H
authors.lastname: Van Vlierberghe
authors.affiliation: Departement of Gastroenterology and Hepatology, UZ Antwerpen, Edegem, Belgium.
authors.forename: Peter
authors.initials: P
authors.lastname: Michielsen
authors.affiliation: Departement of Gastroenterology and Hepatology, CHU Saint-Pierre, Brussels, Belgium.
authors.forename: Marc
authors.initials: M
authors.lastname: van Gossum
authors.affiliation: Departement of Gastroenterology and Hepatology, Hôpital de Jolimont, Haine-Saint-Paul, Belgium.
authors.forename: Marie
authors.initials: M
authors.lastname: de Vos
authors.affiliation: Division of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland.
authors.forename: Astrid
authors.initials: A
authors.lastname: Marot
authors.affiliation: Division of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland.
authors.forename: Christopher
authors.initials: C
authors.lastname: Doerig
authors.affiliation: Departement of Gastroenterology and Hepatology, Hôpital de Jolimont, Haine-Saint-Paul, Belgium.
authors.forename: Jean
authors.initials: J
authors.lastname: Henrion
authors.affiliation: Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, CUB Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium; Division of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland. Electronic address: pierre.deltenre@chuv.ch.
authors.forename: Pierre
authors.initials: P
authors.lastname: Deltenre
mesh_terms: D000428:Alcohol Drinking; D006528:Carcinoma, Hepatocellular; D000431:Ethanol; D016174:Hepacivirus; D006509:Hepatitis B; D006526:Hepatitis C; D006801:Humans; D008103:Liver Cirrhosis; D008113:Liver Neoplasms; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D000431:Ethanol
keywords: Alcohol intake; Cirrhosis; Decompensation; Hepatocellular carcinoma; Survival; Viral eradication