Liver Failure Deaths Continue to Rise in US


Direct-acting antivirals are curing hepatitis C infection, but that has not stopped the number of deaths from acute on chronic liver failure in patients who develop cirrhosis, a Mayo Clinic team reports.

Despite the advent of new direct acting antivirals to fight hepatitis C, acute-on-chronic liver failure (ACLF) is on the rise in the US, a Mayor Clinic, Rochester, MN team reports.

Alina Allen, MD, of the Division of Gastroenterology and Hepatology at the hospital in Rochester, MN, and colleagues published their analysis in Hepatology.

ACLF is defined as liver deterioration resulting in the failure of one of more organs in patients with cirrhosis. Hepatitis C infection is a major cause of liver disease, though not the only one.

The number of hospitalizations for cirrhosis nearly doubled from 371,000 in 2001 to 659,000 in 2011.

The prevalence of ACLF among those hospitalized patients increased form 1.5% to 5% in that time.

Inpatient costs increased twofold for cirrhosis ($4.8 billion to $9.8 billion) while the costs for ACLF increased five times from $320 million to $1.7 billion.

Allen attributes the increase in ACLF to an increase in infectious complications "a recognized leading cause of decompensation and death in this patient population."

The reason the costs have risen so dramatically is partly due to the fact that these patients may get liver transplants.

Mortality rates among these hospitalized patients have improved, but remain high at 50%, she said.

"These data highlight an urgent need for research for pathophysiological mechanisms, effective therapy, as well as for education of healthcare providers of its importance in the care of patients with cirrhosis," the researchers noted.

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