Epidemiological and clinical aspects of liver cirrhosis in adult patients living in Southeastern Anatolia: leading role of HBV in 505 cases

Abstract

Background/aims: Liver cirrhosis is the terminal condition of liver disorders resulting from various causes. Literature lacks data on epidemiological and clinical aspects of liver cirrhosis in Turkey. We aimed to evaluate the main features of liver cirrhosis in this study.

Methodology: We included in the study a total of 505 patients referred to Dicle University Hospital in the last five years and evaluated retrospectively. Demographic features, etiology, clinical findings, disease severity, complications and mortality rates were all recorded.

Results: Of the patients, 136 (27%) were female and 369 were (73%) male. Mean age was 50.4. The etiologic spectrum consisted of 368 HBV (72.9%), 41 HCV (8.1%), 12 alcohol (2.4%). Rate for cryptogenic cirrhosis (CC) was 11.1% with mean age of 45.4. HDV superinfection was present in 17.8%. Most of the patients were in Child-Pugh class B. Number of decompensated cirrhosis cases was 278 (55%). Hepatocellular cancer (HCC) was seen in 8.9% of patients and 88% had HBV with a mean age of 60. HCC was seen more commonly in HDV superinfected patients (p = 0.035). In-patient mortality was observed in 13.2%.

Conclusions: HBV is the leading etiological factor of liver cirrhosis in Southeastern Anatolia and strict measures must be taken against perinatal or horizontal transmission of contagious pathogens. Alcohol had a marginal role in cirrhosis in our region. Although HDV superinfection is decreasing with time, it may increase HCC risk. Patients with cryptogenic cirrhosis were younger and had lower Child-Pugh scores.