Sanchez LO, Karakike E, Njimi H, et al. - In a comparison of patients with decompensated alcohol-associated cirrhosis (DAC), patients with severe alcohol-associated hepatitis (sAH) are more susceptible to develop an infection. Patients who were infected share a similar mortality rate in life-threatening forms of alcohol-associated liver disease (ALD). The results demonstrated that corticosteroid treatment, not sAH, appears to be the main risk factor triggering invasive fungal infections (IFI).

• Researchers recruited a total of 207 patients: 139 with sAH and 68 with DAC. At 90 days, 117 (84%) patients with sAH and 41 (60%) patients with DAC experienced at least one infection episode (P < 0.001).

• Factors correlated with the development of infection were the presence of sAH and baseline MELD score in multivariable analysis.

• In the two groups, bacterial infections represented the most common infection, and only the MELD score was independently correlated with the occurrence of bacterial infection.

• Pneumonia was the most prevalent bacterial infection in both groups, and gram-negative bacilli were the main pathogens.

• They observed invasive fungal infections (IFI) in 20 (14.5%) patients with sAH and 3 (4.5%) patients with DAC (P < 0.05).

• Furthermore, multivariable regression demonstrated that younger age, higher MELD, and corticosteroid therapy were independently correlated with IFI.

• The 90-day cumulative incidence of death was 46% and 41.5% in patients infected with sAH and patients infected with DAC, respectively (P = 0.43).