Cirrhosis is a chronic disease of the liver whose prevalence will dramatically increase during the next decade. Cirrhosis can result from a number of chronic liver diseases such as alcoholic liver disease, chronic viral hepatitis, non-alcoholic steatohepatitis, autoimmune diseases of the liver (primary biliary cirrhosis, primary sclerosing cholangitis, and autoimmune hepatitis). The occurrence of complications indicates the transition to the phase called 'decompensated' (approximately 100,000 patients per year in France); These complications include ascites (30 000 patients per year in France), gastrointestinal bleeding (10,000 episodes / year in France), renal failure and bacterial infections which is very common and often due to the translocation of Gram-negative intestinal bacteria. Mortality in cirrhosis is thus usually a consequence of decompensation or its ensuing complications.
The treatment of choice for decompensated cirrhosis is liver transplantation and many such patients are placed on transplant waiting lists. Therefore predicting the survival time of patients with decompensated alcoholic cirrhosis is highly desirable for determining whether the patient shall be eligible to transplantation. The MELD (Model for End Stage Liver Disease) score is currently used for organ allocation. Although the MELD score predicts 90-day mortality based on bilirubin, INR (international normalized ratio) and serum creatinine, the predisposing factors for death and final events leading to mortality need to be improved.
Thus, the present invention relates to methods for predicting the survival time of patients with decompensated alcoholic cirrhosis, using an 8 gene transcriptional signature as a biomarker.
Scientific publication(s):
J Hepatol., 2016 Dec 28, Weiss E. et al., Type I interferon signaling in systemic immune cells from patients with alcoholic cirrhosis and its association with outcome, doi: 10.1016/j.jhep.2016.12.008.