ETIOLOGICAL SPECTRUM OF CIRRHOSIS IN ANAND DISTRICT, GUJARAT, INDIA

Abstract

Introduction: Alcohol is considered to be a major etiological factor in western world, whereas viral etiology is considered to be predominant cause of cirrhosis in Indian subcontinent. Alcohol consumption and subsequent cirrhosis is increasingly seen in countries such as Japan and India. Early diagnosis and specific treatment for etiology can reverse the cirrhosis. Thus, we planned this study to define etiology for the development of cirrhosis.

Methodology: All the consecutive patients with cirrhosis in last 4 years (February, 2012 to November, 2016) were analyzed for etiology. They underwent for the following investigations: liver function tests, complete blood count, alcohol and drug history, HBsAg, total anti HBc, anti HCV, Alpha Feto Protein, Ferritin, Ceruloplasmin, eye check up for KF ring, α1-antitrypsin, autoimmune hepatitis profile, sonography and doppler of abdomen, 2-D echocardiography, endoscopy and liver biopsy.

Results: A total of 304 cirrhotic patients (217 males, 87 female) were included and etiologies of cirrhosis were as follows [n (%)]:Alcohol in 105 (34.53%), Non Alcoholic Fatty Liver Disease (NAFLD) in 66 (21.71%), Cryptogenic-probable NAFLD in 50 (16.44%), Hepatitis B cirrhosis (HBV) in 35 (11.53%), Hepatitis C cirrhosis (HCV) in 16 (5.26%), Cryptogenic Cirrhosis in 16 (5.26%), Autoimmune liver disease in 7 (2.30%), Metabolic causes in 6 (2%) and Budd-chiari syndrome in 3 (0.98%).

Conclusions: Alcohol remained the most common etiology of cirrhosis most commonly in males. NAFLD is also a major factor for cirrhosis, followed by HBV and HCV. Metabolic, autoimmune and vascular etiologies were seen in few patients. Most etiologies have peculiar age distribution.