BACKGROUND & AIMS Chronic liver disease is a major health burden that produces significant liver-related morbidity and mortality. We aimed to evaluate liver-related outcomes of patients with different causes of chronic liver disease in Australia. METHODS We collected data from 10,933 patients with chronic liver disease assessed by Hepascore (a serum fibrosis model) in Western Australia from 2004 through 2015. We obtained records of liver-related death, transplantation, decompensation, and hepatocellular carcinoma from WA Data Linkage Unit databases. Competing risk analysis was used to calculate the cumulative risk of each clinical endpoint, and risks for clinical endpoints were compared among all causes of chronic liver disease. RESULTS In our final cohort for analysis, 5566 patients had hepatitis C virus (HCV) infection, 1989 had HBV infection, 119 were infected with HBV and HCV, 955 had alcohol-associated liver disease, 1597 had non-alcoholic fatty liver disease (NAFLD), 123 had alcohol-associated liver disease and metabolic risk factors, 561 had autoimmune liver disease without overlap syndrome, and 23 autoimmune overlap syndrome. Significant differences among chronic liver diseases were observed in risk of all-cause death (P < .001), liver-related death (P < .001), liver transplantation (P < .001), and decompensation (P < .001) but not hepatocellular carcinoma (P=.095). Patients with alcohol-associated liver disease had the highest 5-year cumulative risk of liver-related death (17.1%) and the second-highest 5-year cumulative risk of decompensation (29.2%). Multivariate analysis found patients with alcohol-associated liver disease had significantly higher risks of liver-related death and decompensation than patients with HCV infection with hazard ratios (HRs) of 2.39 (95% CI, 1.88-3.03) and 3.42 (95% CI, 2.74-4.27), respectively. Patients with NAFLD had a significantly lower risk of liver related death and decompensation than patients with HCV infection, with HRs of 0.67 (95% CI, 0.48-0.95) and 0.70 (95% CI, 0.52-0.94) respectively. CONCLUSIONS In an analysis of patients in Western Australia, we found patients with alcohol-associated liver disease to have significantly higher risk of decompensation and liver-related death than patients with HCV infection, whereas patients with NAFLD have significantly lower risks of either outcome.

中文翻译：

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澳大利亚慢性肝病患者的长期肝脏相关结果。

背景和目的 慢性肝病是一种主要的健康负担，会导致显着的肝脏相关发病率和死亡率。我们旨在评估澳大利亚不同原因慢性肝病患者的肝脏相关结果。方法 我们收集了 2004 年至 2015 年在西澳大利亚州通过 Hepascore（一种血清纤维化模型）评估的 10,933 名慢性肝病患者的数据。我们从西澳数据链接单位数据库中获取了肝脏相关死亡、移植、失代偿和肝细胞癌的记录. 采用竞争风险分析计算各临床终点的累积风险，比较所有慢性肝病病因的临床终点风险。结果 在我们最后的分析队列中，5566 名患者感染了丙型肝炎病毒 (HCV)，1989 人感染了 HBV，119 人感染了 HBV 和 HCV，955 人有酒精相关性肝病，1597 人有非酒精性脂肪肝（NAFLD），123 人有酒精相关性肝病和代谢危险因素，561 人有自身免疫性肝病无重叠综合征和 23 自身免疫重叠综合征。慢性肝病患者在全因死亡 (P < .001)、肝脏相关死亡 (P < .001)、肝移植 (P < .001) 和失代偿 (P < .001) 风险方面存在显着差异但不是肝细胞癌（P = .095）。酒精相关性肝病患者肝脏相关死亡的 5 年累积风险最高 (17.1%)，失代偿的 5 年累积风险第二高 (29.2%)。多变量分析发现，酒精相关性肝病患者肝脏相关死亡和失代偿的风险显着高于 HCV 感染患者，风险比 (HR) 为 2.39（95% CI，1.88-3.03）和 3.42（95% CI， 2.74-4.27），分别。NAFLD 患者的肝脏相关死亡和失代偿风险显着低于 HCV 感染患者，HR 分别为 0.67（95% CI，0.48-0.95）和 0.70（95% CI，0.52-0.94）。结论 在对西澳大利亚患者的分析中，我们发现酒精相关性肝病患者的失代偿和肝脏相关死亡风险显着高于 HCV 感染患者，而 NAFLD 患者出现任一结果的风险显着降低。