{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:23:32Z","timestamp":1792023812941,"version":"4.4.0"},"reference-count":30,"publisher":"Elsevier BV","issue":"3","license":[{"start":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:00:00Z","timestamp":1630454400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:00:00Z","timestamp":1630454400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["PI13\/02535"],"award-info":[{"award-number":["PI13\/02535"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["EC08\/00087"],"award-info":[{"award-number":["EC08\/00087"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["PI15\/00066"],"award-info":[{"award-number":["PI15\/00066"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["PS09\/00485"],"award-info":[{"award-number":["PS09\/00485"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["PI14\/00876"],"award-info":[{"award-number":["PI14\/00876"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["PI10\/01552"],"award-info":[{"award-number":["PI10\/01552"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","journal-of-hepatology.eu","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Hepatology"],"published-print":{"date-parts":[[2021,9]]},"DOI":"10.1016\/j.jhep.2021.04.022","type":"journal-article","created":{"date-parts":[[2021,4,24]],"date-time":"2021-04-24T11:06:21Z","timestamp":1619262381000},"page":"589-599","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":69,"title":["Bacterial infections adversely influence the risk of decompensation and survival in compensated cirrhosis"],"prefix":"10.1016","volume":"75","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3674-914X","authenticated-orcid":false,"given":"C\u00e0ndid","family":"Villanueva","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agust\u00edn","family":"Albillos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan","family":"Genesc\u00e0","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan C.","family":"Garcia-Pagan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3317-0295","authenticated-orcid":false,"given":"Anna","family":"Brujats","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 L.","family":"Calleja","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carles","family":"Aracil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"Ba\u00f1ares","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9117-5049","authenticated-orcid":false,"given":"Rosa M.","family":"Morillas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Poca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz","family":"Pe\u00f1as","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvador","family":"Augustin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan G.","family":"Abraldes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2036-6133","authenticated-orcid":false,"given":"Edilmar","family":"Alvarado","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7355-7913","authenticated-orcid":false,"given":"Ferran","family":"Torres","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaume","family":"Bosch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jhep.2021.04.022_bib1","doi-asserted-by":"crossref","first-page":"1749","DOI":"10.1016\/S0140-6736(14)60121-5","article-title":"Liver cirrhosis","volume":"383","author":"Tsochatzis","year":"2014","journal-title":"Lancet"},{"key":"10.1016\/j.jhep.2021.04.022_bib2","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.jhep.2005.10.013","article-title":"Natural history and prognostic indicators of survival in cirrhosis: a systematic review of 118 studies","volume":"44","author":"D\u2019Amico","year":"2006","journal-title":"J\u00a0Hepatol"},{"key":"10.1016\/j.jhep.2021.04.022_bib3","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1053\/j.gastro.2007.05.024","article-title":"Hepatic venous pressure gradient predicts clinical decompensation in patients\u00a0with compensated cirrhosis","volume":"133","author":"Ripoll","year":"2007","journal-title":"Gastroenterology"},{"key":"10.1016\/j.jhep.2021.04.022_bib4","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1002\/hep.28906","article-title":"Portal hypertensive bleeding in cirrhosis: risk stratification, diagnosis and management: 2016 practice guidance by the American Association for the Study of Liver Diseases","volume":"65","author":"Garcia-Tsao","year":"2017","journal-title":"Hepatology"},{"key":"10.1016\/j.jhep.2021.04.022_bib5","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1002\/hep.27743","article-title":"Complications and competing risks of death in compensated viral cirrhosis (ANRS CO12 CirVir prospective cohort)","volume":"62","author":"Trinchet","year":"2015","journal-title":"Hepatology"},{"key":"10.1016\/j.jhep.2021.04.022_bib6","doi-asserted-by":"crossref","first-page":"1310","DOI":"10.1016\/j.jhep.2014.01.024","article-title":"Bacterial infections in cirrhosis: a position statement based on the EASL Special Conference 2013","volume":"60","author":"Jalan","year":"2014","journal-title":"J\u00a0Hepatol"},{"key":"10.1016\/j.jhep.2021.04.022_bib7","doi-asserted-by":"crossref","first-page":"2022","DOI":"10.1002\/hep.23264","article-title":"Severe sepsis in cirrhosis","volume":"50","author":"Gustot","year":"2009","journal-title":"Hepatology"},{"key":"10.1016\/j.jhep.2021.04.022_bib8","doi-asserted-by":"crossref","first-page":"2019","DOI":"10.1002\/hep.28330","article-title":"Antibiotic prophylaxis in cirrhosis: good and bad","volume":"63","author":"Fernandez","year":"2016","journal-title":"Hepatology"},{"key":"10.1016\/j.jhep.2021.04.022_bib9","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1136\/gutjnl-2015-310275","article-title":"Bacterial infection in compensated viral cirrhosis impairs 5-year survival (ANRS CO12 CirVir prospective cohort)","volume":"66","author":"Nahon","year":"2017","journal-title":"Gut"},{"key":"10.1016\/j.jhep.2021.04.022_bib10","doi-asserted-by":"crossref","first-page":"1597","DOI":"10.1016\/S0140-6736(18)31875-0","article-title":"\u03b2 blockers to prevent decompensation of cirrhosis in patients with clinically significant portal hypertension (PREDESCI): a randomised, double-blind, placebo-controlled multicentre trial","volume":"393","author":"Villanueva","year":"2019","journal-title":"Lancet"},{"key":"10.1016\/j.jhep.2021.04.022_bib11","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1016\/S0140-6736(07)61602-X","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"370","author":"Von Elm","year":"2007","journal-title":"Lancet"},{"key":"10.1016\/j.jhep.2021.04.022_bib12","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1016\/j.jhep.2010.05.004","article-title":"EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis","volume":"53","year":"2010","journal-title":"J\u00a0Hepatol"},{"key":"10.1016\/j.jhep.2021.04.022_bib13","doi-asserted-by":"crossref","first-page":"1368","DOI":"10.1053\/j.gastro.2018.12.005","article-title":"Epidemiology and effects of bacterial infections in patients with cirrhosis worldwide","volume":"156","author":"Piano","year":"2019","journal-title":"Gastroenterology"},{"key":"10.1016\/j.jhep.2021.04.022_bib14","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1016\/j.jhep.2018.03.024","article-title":"EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosis","volume":"69","year":"2018","journal-title":"J\u00a0Hepatol"},{"issue":"Suppl1","key":"10.1016\/j.jhep.2021.04.022_bib15","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1016\/S0168-8278(12)60002-6","article-title":"Management of bacterial infections in cirrhosis","volume":"56","author":"Fernandez","year":"2012","journal-title":"J\u00a0Hepatol"},{"key":"10.1016\/j.jhep.2021.04.022_bib16","series-title":"ICH E9 statistical principles for clinical trials","year":"2013"},{"key":"10.1016\/j.jhep.2021.04.022_bib17","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1002\/hep.27598","article-title":"The clinical course of cirrhosis: the importance of multi-state models and competing risks analysis","volume":"62","author":"Jepsen","year":"2015","journal-title":"Hepatology"},{"key":"10.1016\/j.jhep.2021.04.022_bib18","doi-asserted-by":"crossref","first-page":"1385","DOI":"10.1016\/j.jhep.2014.08.010","article-title":"Cirrhosis-associated immune dysfunction: distinctive features and clinical relevance","volume":"61","author":"Albillos","year":"2014","journal-title":"J\u00a0Hepatol"},{"key":"10.1016\/j.jhep.2021.04.022_bib19","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1016\/j.jhep.2019.10.003","article-title":"The gut-liver axis in liver disease: pathophysiological basis for therapy","volume":"72","author":"Albillos","year":"2020","journal-title":"J\u00a0Hepatol"},{"key":"10.1016\/j.jhep.2021.04.022_bib20","doi-asserted-by":"crossref","first-page":"1272","DOI":"10.1016\/j.jhep.2015.07.004","article-title":"Mechanisms of decompensation and organ failure in cirrhosis: from peripheral arterial vasodilation to systemic inflammation hypothesis","volume":"63","author":"Bernardi","year":"2015","journal-title":"J\u00a0Hepatol"},{"key":"10.1016\/j.jhep.2021.04.022_bib21","doi-asserted-by":"crossref","first-page":"1210","DOI":"10.1053\/jhep.2003.50447","article-title":"Systemic, renal, and hepatic hemodynamic derangement in cirrhotic patients with spontaneous bacterial peritonitis","volume":"38","author":"Ruiz-del-Arbol","year":"2003","journal-title":"Hepatology"},{"key":"10.1016\/j.jhep.2021.04.022_bib22","doi-asserted-by":"crossref","first-page":"2044","DOI":"10.1002\/hep.23918","article-title":"Bacterial DNA translocation is associated with systemic circulatory abnormalities and intrahepatic endothelial dysfunction in patients with cirrhosis","volume":"52","author":"Bellot","year":"2010","journal-title":"Hepatology"},{"key":"10.1016\/j.jhep.2021.04.022_bib23","doi-asserted-by":"crossref","first-page":"936","DOI":"10.1126\/science.1214935","article-title":"Disease tolerance as a defense strategy","volume":"335","author":"Medzhitov","year":"2012","journal-title":"Science"},{"key":"10.1016\/j.jhep.2021.04.022_bib24","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1038\/ajg.2017.19","article-title":"Bacterial infections change natural history of cirrhosis irrespective of liver disease severity","volume":"112","author":"Dionigi","year":"2017","journal-title":"Am J Gastroenterol"},{"key":"10.1016\/j.jhep.2021.04.022_bib25","doi-asserted-by":"crossref","first-page":"1246","DOI":"10.1053\/j.gastro.2010.06.019","article-title":"Infections in patients with cirrhosis increase mortality four-fold and should be used in determining prognosis","volume":"139","author":"Arvaniti","year":"2010","journal-title":"Gastroenterology"},{"key":"10.1016\/j.jhep.2021.04.022_bib26","doi-asserted-by":"crossref","first-page":"2328","DOI":"10.1002\/hep.25947","article-title":"Second infections independently increase mortality in hospitalized patients with cirrhosis","volume":"56","author":"Bajaj","year":"2012","journal-title":"Hepatology"},{"key":"10.1016\/j.jhep.2021.04.022_bib27","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1016\/j.jhep.2015.10.018","article-title":"Treatment with non-selective beta-blockers is associated with reduced severity of systemic inflammation and improved survival of patients with acute-on-chronic liver failure","volume":"64","author":"Mookerjee","year":"2016","journal-title":"J\u00a0Hepatol"},{"key":"10.1016\/j.jhep.2021.04.022_bib28","doi-asserted-by":"crossref","first-page":"1293","DOI":"10.1002\/hep.28992","article-title":"Effects of an intensive lifestyle intervention program on portal hypertension in patients with cirrhosis and obesity: the SportDiet study","volume":"65","author":"Berzigotti","year":"2017","journal-title":"Hepatology"},{"key":"10.1016\/j.jhep.2021.04.022_bib29","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1002\/hep.30412","article-title":"Management of sepsis in patients with cirrhosis: current evidence and practical approach","volume":"70","author":"Simonetto","year":"2019","journal-title":"Hepatology"},{"key":"10.1016\/j.jhep.2021.04.022_bib30","doi-asserted-by":"crossref","first-page":"1084","DOI":"10.1016\/j.jhep.2017.05.007","article-title":"Targeting the gut-liver axis in liver disease","volume":"67","author":"Wiest","year":"2017","journal-title":"J\u00a0Hepatol"}],"container-title":["Journal of Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0168827821002579?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0168827821002579?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:55:17Z","timestamp":1777510517000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0168827821002579"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9]]},"references-count":30,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021,9]]}},"alternative-id":["S0168827821002579"],"URL":"https:\/\/doi.org\/10.1016\/j.jhep.2021.04.022","relation":{},"ISSN":["0168-8278"],"issn-type":[{"value":"0168-8278","type":"print"}],"subject":[],"published":{"date-parts":[[2021,9]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Bacterial infections adversely influence the risk of decompensation and survival in compensated cirrhosis","name":"articletitle","label":"Article Title"},{"value":"Journal of Hepatology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jhep.2021.04.022","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2021 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.","name":"copyright","label":"Copyright"}]}}