Complications and competing risks of death in compensated viral cirrhosis (ANRS CO12 CirVir prospective cohort)

• DOI: 10.1002/hep.27743
• Publication Date: 2015-02-13T04:01:59Z
• Authors: Jean‐Claude Trinchet; Valérie Bourcier; Cendrine Chaffaut; Mohand Ait Ahmed; Setty Allam; Patrick Marcellin; Dominique Guyader; Stanislas Pol; Dominique Larrey; Victor De Lédinghen; Denis Ouzan; Fabien Zoulim; Dominique Roulot; Albert Tran; Jean‐Pierre Brono...; Jean‐Pierre Zarski; Odile Goria; Paul Calès; Jean‐Marie Péron; Laurent Alric; Marc Bourlière; Philippe Mathurin; Jean‐Frédéric Blanc; Armand Abergel; Lawrence Serfaty; Ariane Mallat; Jean‐Didier Grangé; Catherine Buffet; Yannick Bacq; Claire Wartelle; Thông Dao; Yves Benhamou; Christophe Pilette; Christine Silvain; Christos Christidis; Dominique Capron; Gérard Thiefin; Sophie Hillaire; Vincent Di Martino; Pierre Nahon; Sylvie Chevret
• Keywords: Decompensation; Liver disease; Cumulative incidence; Hepatitis C

Various critical events, liver related or not, occur in patients with compensated cirrhosis, but their respective burden remains to be prospectively assessed. The aim of this prospective cohort study involving 35 French centers was capture the whole spectrum complications occurring viral cirrhosis (VC) using competing risks analyses. Inclusion criteria were: histologically proven resulting from hepatitis C virus (HCV) B (HBV); Child‐Pugh A; and no previous hepatic complications. considered as a multistate disease model, cumulative incidences (CumIs) events were estimated framework. A total 1,654 enrolled 2006 2012 (HCV, 1,308; HBV, 315; HCV‐HBV, 31). During median follow‐up 34 months, at least one nodule detected 271 patients, confirmed hepatocellular carcinoma (HCC) 128 (4‐year cumI: 10.5%) cholangiocarcinoma 3. HCC incidence higher HCV 11.4% vs. 7.4%; P = 0.05). fulfilled Milan 79.3%, leading curative treatment 70.4%. Liver decompensation occurred more frequently 10.8% 3.6%; 0.0004). Virological eradication/control achieved 34.1% 88.6% HBV associated marked decrease HCC, decompensation, bacterial infection incidences. Survival shorter 91.6% 97.2%; 0.0002). Death (n 102; missing data: 6) attributed 48 (47%; cancer: n 18; miscellaneous, 30) extrahepatic causes infection: 13; cancers: 10; cardiovascular events: 5; 20). Conclusion : After 3 years follow‐up, still explained half deaths VC. strong linked virological eradication/control. (H epatology 2015;62:737–750)