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To the editor, We read with great interest the study by Gratacós-Ginès et al,1 suggesting that recurrent alcohol-associated hepatitis (AH) is common and associated with increased mortality when compared with the index episode of alcoholic hepatitis. Data were lacking regarding recurrent AH, and this elegant study is most than welcome. However, we would like to underline some aspects that should be kept in mind when reading the article. First, important data, such as the number of patients with definite, ie, histologically proven AH, are missing. Indeed, a recent study underlined the suboptimal accuracy of noninvasive methods to diagnose AH,2 which may conduct the reader to hypothesize that patients with other causes of acute decompensation may have been included. Moreover, several years ago, we showed that patients with a typical presentation of severe AH had a definite AH in only 80% of cases in case of bleeding (90 patients in the current study).3 Second, it would also have been interesting to provide data on treatments that could have changed the global prognosis of the patients who recovered after the first AH, such as nonselective beta-blockers or TIPS. One can hypothesize that patients with AH and concomitant acute variceal bleeding (n=76) would have been candidates for preemptive TIPS placement. Indeed, the median Child-Pugh score was 10 during the first AH episode, and preemptive TIPS is currently indicated in patients with Child-Pugh C 10–13 cirrhosis.4 Last, the authors found that 51% of patients who were abstinent after first AH did not develop recurrent AH. We do believe that this result should be cautiously interpreted, especially because of the retrospective design of the study: one can hypothesize that patients with significant liver-related events were referred more often, those more prone to be nonabstinent. In conclusion, we agree with the authors’ statement that patients surviving an episode of AH should undergo intense alcohol use disorder therapy. We also do believe that optimal medical management, including liver biopsies, nonselective beta-blockers, or TIPS when indicated, are mandatory.