Etiology of liver cirrhosis in Brazil: chronic alcoholism and hepatitis viruses in liver cirrhosis diagnosed in the state of Espírito Santo

Abstract

OBJECTIVES:To report the etiology of liver cirrhosis cases diagnosed at the University Hospital in Vitoria, Espirito Santo, Brazil.METHODS:The medical charts of patients with liver cirrhosis who presented to the University Hospital in Vitoria were reviewed. Chronic alcoholism and the presence of hepatitis B or C infections (HBV and HCV, respectively) were pursued in all cases.RESULTS:The sample consisted of 1,516 cases (male:female ratio 3.5:1, aged 53.2±12.6 years). The following main etiological factors were observed: chronic alcoholism alone (39.7%), chronic alcoholism in association with HBV or HCV (16.1%), HCV alone (14.5%) and in association with alcoholism (8.6%) (total, 23.1%), and HBV alone (13.1%) and in association with alcoholism (7.5%, total 20.6%). The remaining etiologies included cryptogenic cases (9.8%) and other causes (6.0%). The mean patient age was lower and the male-to-female ratio was higher in the cirrhosis cases that were associated with alcoholism or HBV compared with other causes. Intravenous drug abuse and a history of surgery or blood transfusion were significantly associated with HCV infection. Hepatocellular carcinoma was present at the time of diagnosis in 15.4% of cases. Chronic alcoholism associated with HCV infection was significantly associated (p<0.001) with reduced age (at the time of cirrhosis diagnosis) and increased prevalence of hepatocellular carcinoma (p = 0.052).CONCLUSION:Alcoholism, HCV and HBV are the main factors associated with liver cirrhosis in the state of Espirito Santo. Chronic alcoholism associated with HCV infection reduced the age of patients at the time of liver cirrhosis diagnosis.

Mortality from liver cirrhosis in Espírito Santo State, Brazil

“…This reliability is also reinforced because the three main aetiological factors of cirrhosis were carefully investigated in each patient before death. In addition, the prevalence of different aetiologies observed in this sample was very similar to that observed in 1,516 cases of liver cirrhosis diagnosed at the University Hospital in Vitória between 1993 and 2010 6 . The frequency of chronic alcoholism in the reviewed sample was lower than that retrieved from death certificates, suggesting overestimation of alcoholism and under estimation of hepatitis B or C viruses as aetiology of liver cirrhosis recorded in death certificates.…”

“…1,2 . Studies on aetiology and mortality from liver cirrhosis in Brazil are scarce 3,4,5,6 . For these reasons we studied the mortality and the aetiology of liver cirrhosis in Espírito Santo State by analysing the death certificates from 2000 to 2010.…”

Hepatitis virus and hepatocellular carcinoma in Brazil: a report from the State of Espírito Santo

“…These data refl ect the high prevalence of alcohol abuse in metropolitan Vitória (27.8% in men; 10.8% in women) 23 and the high frequency of chronic alcoholism in the etiology of liver cirrhosis in the State of Espírito Santo 21 . In addition, this observation confi rms the importance of the abusive use of alcohol in the development of HCC 6,17,18,24 .…”

“…This variability refl ects differences in exposure to risk factors for chronic liver disease in our county, where alcoholism and chronic infection with hepatitis B virus are more prevalent than in other regions of Brazil or Latin America 21 . The high frequency of HBV associated with HCC reported here (37.6% of the cases) is noteworthy.…”

Application of the Outcome Present State Test Model in a Patient with Liver Cirrhosis: A Case Study

“…In Brazil, studies focused on the etiology and mortality from liver cirrhosis is scarce [10][11][12] . However, it is known that the prevalence of liver cirrhosis has increased in the Brazilian population, especially among the elderly.…”