Alcoholic Hepatitis in Latin-America: A Prospective and Multicentric Study (AH-LATIN).

Study Overview
=================
Brief Summary
-----------------
The primary objective of this study is to determine the prevalence of AH in addition to its clinical characteristics and in-hospital mortality of patients that are hospitalized for AH in different hospitals across Latin American countries This study is carried out in different health centers throughout America, with all the countries belonging to the Latin American Association for the study of liver diseases (ALEH) more Canada and United States This would allow us to better understand the epidemiology of AH in our region and thus implement prevention measures with more solid data. Importantly, this would allow us to optimize therapeutic measures

Detailed Description
-----------------
This study is sponsored and organized by the group Latin American of interest special in the study of the disease hepatic Alcohol (ALEH-GLEHA), belonging to the Latin American Association for the study of the hepatic illnesses (ALEH), which is an association non-profit that has nearly 1,000 members from most of the countries of Latin America. All patients admitted to the hospital with suspected alcoholic hepatitis will be evaluated to see if they can be included in the study. Patients will be enrolled according with the inclusion and exclusion criteria. The investigators will take a blood sample to be analyzed as part of the necessary data record, for the study of genes and identification of proteins involved in the development, evolution and prognosis of alcoholic hepatitis. If the medical doctor had instructed to perform a liver biopsy, voluntarily the investigators will ask to participants donate a small share of the surplus of histological sample To achieve this, it is necessary to generate a data bank of clinical information and biological samples (blood, urine, bile, stools, salivary sample or tissue samples) that allows studying the various factors involved in the development and prognosis of this disease in the countries of the Americas. The investigators will make a clinical follow-up for a year, consisting of phone calls to complete a questionnaire about participant's health. These calls will be made in month 1, 3, 6 and 12 subsequent to participant's hospital discharge. The data collected are identified by a code and only the study physicians can correlate the data with the participants and medical history, so the participant's identity will not be shared. There is no financial compensation associated with the study

Official Title
-----------------
Alcoholic Hepatitis in Latin-America: A Prospective and Multicentric Study (AH-LATIN).

Conditions
-----------------
Hepatitis, Alcoholic

Intervention / Treatment
-----------------
* Biological: blood withdraw


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Consumption of more than 3 drinks per day (40 g) in women and more than 4 drinks per day (50-60 g) in men. Excessive alcohol consumption for more than 5 years in a row or interrupted. No more than 60 days of abstinence before the onset of jaundice. Bilirubin levels > 3 mg / dL (> 50 μmol / L), AST> 50 IU / mL, AST / ALT ratio> 1.5. Absence of other causes of hepatic disease. Exclusion Criteria: Age < 18 years Pregnancy or lactation Alcohol abstinence for more than 60 days before the event that led to hospitalization. Aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT) levels beyond 400 IU/ml. Presence of drug-induced liver injury (DILI), ischemic hepatitis, biliary duct obstruction, viral hepatitis, autoimmune hepatitis or Wilson's disease. Hepatocellular carcinoma beyond the Milan criteria (ie, a single lesion < 5 cm or no more than 3 lesions, the largest of which measures ≤ 3 cm). Extrahepatic neoplasia with a life expectancy of less than 6 months. History of severe extrahepatic disease (eg, chronic kidney failure requiring hemodialysis, severe heart disease (NYHA class ≥ 3), severe chronic lung disease that confers a survival of less than 6 months. Patients who cannot provide informed consent and that lack a responsible legal substitute.

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 99 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Intervention/Treatment |
| --- |
|Biological: blood withdraw|venous blood sampling|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of subjects hospitalized with alcoholic hepatitis who die at 30, 60 and 90 days. | To determine the clinical characteristics, complications and in-hospital mortality of patients who are hospitalized for alcoholic hepatitis in different establishments in America. To achieve this, it is necessary to generate a data bank of clinical information and biological samples (blood, urine, bile, stools, salivary sample or tissue samples) that allows studying the various factors involved in the development and prognosis of this disease in the countries of the Americas. This will help us to know aspects of the highest prevalence and mortality from alcoholic hepatitis in Latin Americans in comparison to other regions of the world and useful information in the prevention and early diagnosis of this disease. | 90 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of subjects hospitalized with alcoholic hepatitis who develop complications (infection, gastrointestinal bleeding, renal failure, etc.) | Inquire about the incidence of infections and prevalence of infections resistant to antibiotics in patients hospitalized for alcoholic hepatitis. | 4 years | 
| Number of subjects with alcoholic hepatitis who are cataloged as responders by Lille score. | with the data bank researches will be able to track patients through health questionnaires | 4 years | 
| Mean Model of End-Stage Liver Disease (MELD) score at day 0, 30, 60 and 90. | with the data bank researches will be able to track patients through health questionnaires | 4 years | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
alcoholic, liver disease, cirrhosis