ArticleBMC gastroenterology2025
Etiology of cirrhosis is associated with risk of hepatic decompensation and hepatocellular carcinoma.
Article in BMC gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- A novel oncogene, leucine-rich repeat protein 1, mediates hypoxia-induced hepatocellular carcinoma progression.Functional & integrative genomics · 2025Article
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13 authors.
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Abstract
backgroundThe impact of the changing epidemiology from viral to non-viral etiologies of cirrhosis on the burden of liver-related complications remains unclear.
methodsWe conducted a retrospective cohort study of adult patients with cirrhosis and an index outpatient visit between January and December 2015 at two U.S. health systems. We excluded patients with a history of hepatocellular carcinoma (HCC) or both prevalent ascites and hepatic encephalopathy. Fine-Gray sub-distribution hazard models were used to characterize time-to-incident hepatic decompensation and incident HCC through 2020, with liver transplantation and death as competing events, and multivariable Fine-Gray regression was used to identify associated factors.
resultsWe identified 1029 patients (median age 58 years, 54.9% male, 19.5% non-Hispanic White). Over a median follow-up of 84.7 months, 36.4% developed incident hepatic decompensation (46.7% ascites, 21.1% hepatic encephalopathy, and 32.3% ascites plus hepatic encephalopathy), 14.5% developed HCC, 2.0% underwent transplant, and 23.0% died. The cumulative 1-, 2-, and 3-year incidence of hepatic decompensation were 7.0%, 10.8%, and 16.3% and incidence of HCC were 3.0%, 5.0%, and 6.9%, respectively. Compared to viremic hepatitis C, higher risk of hepatic decompensation was associated with metabolic dysfunction-associated steatotic liver disease (MASLD) (sHR 1.52, 95% CI 0.94 - 2.45) and alcohol-associated cirrhosis (sHR 1.68, 95%CI 1.10 - 2.57), while incident HCC was inversely associated with MASLD (sHR 0.27; 95% CI 0.12-0.59) and alcohol-associated cirrhosis (sHR 0.45; 95% CI 0.23-0.84).
conclusionIncreasing proportions of non-viral liver disease will likely lead to a greater burden of hepatic decompensation and reduced HCC in contemporary populations.
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