Effects of Rifaximin in Patients With Acute Alcoholic Hepatitis

Exclusion Criteria

• •Hypersensitivity to Rifaximin
• •Advanced Chronic or Terminal illness. Advanced Chronic illness will be defined as: all conditions evolved into a clinical stage to limit the patient's functional status (eg, heart failure NYHA\> II, COPD PCO2\> 50 mmHg or PO2 \<60 mmHg, stroke or other disabling neurological disease, disabling or uncontrolled oncological conditions, etc ...).
• •Terminal illness will be defined as any clinical conditions with a survival expectancy less than 3 months
• •Hepatocellular carcinoma (previously diagnosed) beyond Milan's criteria.
• •Complete portal vein thrombosis (previously diagnosed).
• •Autoimmune liver disease.
• •Hepatitis B and C and HIV infection (anti-HCV, surface HBV antigen and anti-HIV positive).
• •Pregnancy or nursing.
• •Use of Rifaximin during the previous 2 months.
• •Treatment with Pentoxifylline.
• •Lack of informed consent.
• •Removal criteria:
• •Lack of histological confirmation of Alcoholic Hepatitis during the first 7 days after inclusion.
• •Because there are no non-diagnostic tools to diagnose alcoholic hepatitis, histological confirmation is required in all patients (preferably through a transjugular biopsy): alcoholic hepatitis will be diagnosed on the presence of the following histologic features:
• •Hepatocellular damage (eg, hepatocyte ballooning and presence of Mallory-Denk bodies).
• •Inflammatory infiltrate (predominantly polymorphonuclear cells). Pericellular or sinusoidal fibrosis.
• •Hepatocellular carcinoma beyond Milan's criteria diagnosed during the first 7 days after inclusion.
• •Complete portal vein thrombosis diagnosed during the first 7 days after inclusion.
• •Protocol violation.
• •Severe adverse event directly related with Rifaximin.