Liver Cirrhosis seen in GI Clinics of Ahvaz, Iran

Abstract

Background: Liver cirrhosis is an end-stage condition fornumerous chronic liver diseases. Limited data exists on the epidemiology,natural history and complications of liver cirrhosis in Ahvaz, Iran. In a cross-sectional study we have retrospectively evaluated 165 patients from September 1, 1999 until September 1, 2008.

Materials and Methods: Patients with evidence of cirrhosis of the liver seen on abdominal ultrasound were enrolled. The diagnosis was based on clinical, functional and morphological data.The etiological profile was established by determining viral and autoimmune markers, and by metabolic screening.Patientswho were not confirmed to be cirrhotic were excluded from this study. All cases were studied to determine etiological factors, complications and disease prognosis. Data were recorded on a questionnaire.

Results: A total of 165 patients were studied, of which there were 114(67%)males and 51(33%) females. The mean age was 47 years. The majority of patients [70 cases (42.4%)] had evidence of HBV infection. Of HBs Ag-positive patients, 31(43.2%) were HDV Ab positive with a mean age of 41.6 years. There wasno significant difference by sex among cirrhotic patients (p›0.05). Other cases included 23 (14%) patients with autoimmune hepatitis (AIH), 15(9.1%)had HCV infection, 2(1.2%)had evidence of Wilson's disease and no etiological factors were recorded in 55 (33.3%) patients. Ascites was present in 32% of cases, splenomegaly in 29%, esophageal varices in 38%, fundal varices in 2%, peptic ulcer in 8%, acute variceal hemorrhage in 8%, various grades of hepatic encephalopathy in 1%, and hepatocellular carcinoma in 6% of patients. When cirrhotic patients were grouped according to Child-Pugh classification,19% were in class A, 30% were in class B, and 51% comprised class C.

Conclusion: HBV infection was the major risk factor for cirrhosis in this study and ascites was the most common complication. There were more patients with Child-Pugh class C cirrhosis than those in classes B and A. A multidisciplinary approach for the prevention and control of the increase in HBV infection must be adopted in order to inform the public about the seriousness of its complications and possible modes of transmission.