Natural History of Cirrhosis: Changing Trends in Etiology Over the Years.
Adult
Aged
Carcinoma, Hepatocellular
/ complications
Female
Hepacivirus
Hepatitis B virus
Hepatitis, Viral, Human
/ complications
Humans
Liver Cirrhosis
/ complications
Liver Neoplasms
/ complications
Logistic Models
Male
Middle Aged
Non-alcoholic Fatty Liver Disease
/ complications
Risk Factors
Severity of Illness Index
Cirrhosis
Hepatitis B virus
Hepatitis C virus
Hepatocellular carcinoma
Nonalcoholic fatty liver disease
Nonalcoholic steatohepatitis
Journal
Digestive diseases (Basel, Switzerland)
ISSN: 1421-9875
Titre abrégé: Dig Dis
Pays: Switzerland
ID NLM: 8701186
Informations de publication
Date de publication:
2021
2021
Historique:
received:
21
08
2020
accepted:
02
11
2020
pubmed:
4
11
2020
medline:
17
7
2021
entrez:
3
11
2020
Statut:
ppublish
Résumé
The aims of the present study were to investigate the natural history of cirrhosis and to determine trends in the etiology of cirrhosis. Between January 2001 and January 2018, a total of 1,341 patients had been diagnosed with cirrhosis and were included. A total of 898 cirrhotic patients, who were followed up for at least 6 months were included into the analysis. The median age was 54 years. The median Child-Pugh and MELD scores were 7.5 and 11, respectively. Ascites (51%) was the most common causes of decompensation. Chronic viral hepatitis was the most frequent cause of cirrhosis (58%). Hepatitis B virus (HBV) infection was the main etiology (34%), followed by hepatitis C virus (HCV) infection (18%). Among 129 patients with cryptogenic cirrhosis (CC), 60 had metabolic abnormalities. If these 60 patients with CC were considered to have nonalcoholic fatty liver disease (NAFLD)-related cirrhosis, the proportion of NAFLD-related cirrhosis increased from 1.8 to 8.0%. At admission, 74 patients (8%) had been diagnosed with hepatocellular carcinoma (HCC). A new HCC developed in 80 patients during the follow-up period. The probability of developing HCC was 3.9% at 12 months. Logistic regression analysis showed that the development of HCC was significantly associated with older age (p < 0.001), male gender (p < 0.001), viral etiology (p = 0.026), and baseline high aspartate aminotransferase level (p = 0.01). Overall, 104 cirrhotic patients died. HBV and HCV remain the leading causes of etiology in cirrhosis and HCC. However, NAFLD-related cirrhosis is recognized as a growing burden.
Sections du résumé
BACKGROUND AND GOALS
OBJECTIVE
The aims of the present study were to investigate the natural history of cirrhosis and to determine trends in the etiology of cirrhosis.
METHODS
METHODS
Between January 2001 and January 2018, a total of 1,341 patients had been diagnosed with cirrhosis and were included.
RESULTS
RESULTS
A total of 898 cirrhotic patients, who were followed up for at least 6 months were included into the analysis. The median age was 54 years. The median Child-Pugh and MELD scores were 7.5 and 11, respectively. Ascites (51%) was the most common causes of decompensation. Chronic viral hepatitis was the most frequent cause of cirrhosis (58%). Hepatitis B virus (HBV) infection was the main etiology (34%), followed by hepatitis C virus (HCV) infection (18%). Among 129 patients with cryptogenic cirrhosis (CC), 60 had metabolic abnormalities. If these 60 patients with CC were considered to have nonalcoholic fatty liver disease (NAFLD)-related cirrhosis, the proportion of NAFLD-related cirrhosis increased from 1.8 to 8.0%. At admission, 74 patients (8%) had been diagnosed with hepatocellular carcinoma (HCC). A new HCC developed in 80 patients during the follow-up period. The probability of developing HCC was 3.9% at 12 months. Logistic regression analysis showed that the development of HCC was significantly associated with older age (p < 0.001), male gender (p < 0.001), viral etiology (p = 0.026), and baseline high aspartate aminotransferase level (p = 0.01). Overall, 104 cirrhotic patients died.
CONCLUSION
CONCLUSIONS
HBV and HCV remain the leading causes of etiology in cirrhosis and HCC. However, NAFLD-related cirrhosis is recognized as a growing burden.
Identifiants
pubmed: 33142287
pii: 000512746
doi: 10.1159/000512746
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
358-365Informations de copyright
© 2020 S. Karger AG, Basel.