Influence of Liver Biopsy on Abstinence in Alcohol-Dependent Patients

• Published in: Alcohol and alcoholism (Oxford) Vol. 43; no. 5; pp. 559 - 563
• Main Authors: Trabut, Jean-Baptiste, Plat, Arnaud, Thepot, Véronique, Fontaine, Hélène, Vallet-Pichard, Anaïs, Nalpas, Bertrand, Pol, Stanislas
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.09.2008; Oxford Publishing Limited (England)
• Subjects: Abstinence; Addictive behaviors; Adult; Adult and adolescent clinical studies; Alcoholics; Alcoholism; Alcoholism - pathology; Alcoholism - psychology; Alcoholism and acute alcohol poisoning; Biological and medical sciences; Biopsy; Biopsy - psychology; Chi-Square Distribution; Female; Humans; Liver; Liver diseases; Liver Diseases, Alcoholic - pathology; Liver Diseases, Alcoholic - psychology; Liver Function Tests; Logistic Models; Male; Medical sciences; Middle Aged; Motivation; Paris; Patients; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Retrospective Studies; Statistics, Nonparametric; Temperance - psychology; Toxicology; Paris; Human; Alcoholic beverage; Anatomic pathology; Poison withdrawal; Motivation; Digestive system; Biopsy; Alcoholism; Liver; Dependence; Disintoxication; Abstinence
• ISSN: 0735-0414; 1464-3502
• DOI: 10.1093/alcalc/agn046

Background: Liver biopsy indication for the evaluation of alcoholic liver disease is controversial. Our aim was to investigate the influence of the biopsy on the patients’ motivation for abstinence. Methods: We retrospectively analysed, in a population of 324 patients hospitalized for alcohol withdrawal, the impact of liver biopsy on the following clinical outcomes: rapid loss to follow-up (immediately after hospital discharge), early relapse (< 3 months) and long-lasting abstinence (> 12 months). The biopsy was performed in 136 patients who had liver enzymes perturbations. Hepatic lesions were graded as mild (isolated steatosis and/or non-bridging fibrosis), moderate (bridging fibrosis and/or moderate alcoholic hepatitis) or severe (cirrhosis and/or marked alcoholic hepatitis) in 66 (48%), 41 (30%) and 29 (21%) cases, respectively. Results: In univariate analysis, patients who had a liver biopsy were less likely to be rapidly lost to follow-up (12% versus 27%, P = 0.003) but had a lower rate of long-term abstinence (20% versus 34%, P = 0.025). In multivariate analysis, age was the only factor significantly associated with clinical outcome: older patients had higher rate of long-term abstinence (OR = 1.041; P = 0.010). Among patients who had a biopsy, those with severe hepatic lesions had a lower rate of rapid relapse than those with moderate or mild lesions (32% versus 68% and 56%, P = 0.018) but the rate of long-term abstinence was similar in the three groups. Conclusion: This observational study does not support the notion that liver biopsy has a significant influence on the maintenance of alcohol abstinence in patients with alcoholic liver disease.