Natural History of Cirrhosis: Changing Trends in Etiology Over the Years

Abstract

Background and goals: The aims of the present study were to investigate the natural history of cirrhosis and to determine trends in the etiology of cirrhosis. Methods: Between January 2001 and January 2018, a total of 1341 patients had been diagnosed with cirrhosis were included. Results: A total of 898 cirrhotic patients, who were followed for at least six 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 non-alcoholic 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. In conclusion: HBV and HCV remain the leading causes of etiology in cirrhosis and HCC. However, NAFLD-related cirrhosis is recognized is recognized as a growing burden.

Characteristics of patients with hepatocellular carcinoma: A multicenter study

“…[12,13] A recent study in Turkey reported that NAFLD was one of the most common causes of cirrhosis, accounting for 8.5% of cases. [15] In the present study, 33% of the HCC patients were obese, 30% had DM, and 36% had hypertension. NAFLD-related cir- rhosis was one of the most frequent causes of HCC, accounting for 10% of cases.…”

“…[6] In Turkey, HBV and HCV infections remain major causes of liver-related morbidity and mortality and the most common causes of cirrhosis and HCC in more than 50% of HCC cases. [7][8][9][10][11][12][13][14][15] The data regarding the etiologic and clinical characteristics of HCC in a large cohort of Turkish patients are limited. The aim of the present study was to examine the etiology of HCC by underlying cause and to determine the characteristics and clinical features of patients with HCC in Turkey.…”

Treatment initiation rates of patients with positive anti-hepatitis C virus results in tertiary hospitals in Turkey: a retrospective, cross-sectional chart review (Lost-C Study)

“…14 Studies have shown that HCV is the second most common cause of both liver cirrhosis and HCC in Turkey. 15,16 Today, HCV infection is a disease that can be successfully treated. With the use of DAA drugs, the success rate in the treatment of HCV infection has improved tremendously.…”

Cerrahi prosedürler öncesi anti-HCV taraması: Hastalar yeterince bilgi sahibi mi?

“…HCV enfeksiyonu; erken döneminde asemptomatik olduğu için sinsi seyirli, enfekte olanların %60-80'inin kronikleştiği, karaciğer sirozunun ve hepatosellüler karsinomun (HCC) en sık sebeplerinden biridir. HCV'nin hem karaciğer sirozunun hem de HCC'nin Türkiye'de 2. sık sebebi olduğu yapılan çalışmalarla ortaya konmuştur (2,8). HCV enfeksiyonu günümüzde başarı ile tedavi edilebilen bir hastalıktır.…”