Type and cause of liver disease in Korea: single-center experience, 2005-2010

Abstract

Background/aims: The aim of this study was to describe the types and causes of liver disease in patients from a single community hospital in Korea between April 2005 and May 2010.

Methods: A cohort of patients who visited the liver clinic of the hospital during the aforementioned time period were consecutively enrolled (n=6,307). Consistent diagnostic criteria for each liver disease were set by a single, experienced hepatologist, and the diagnosis of all of the enrolled patients was confirmed by retrospective review of their medical records.

Results: Among the 6,307 patients, 528 (8.4%) were classified as acute hepatitis, 3,957 (62.7%) as chronic hepatitis, 767 (12.2%) as liver cirrhosis, 509 (8.1%) as primary liver cancer, and 546 (8.7%) as a benign liver mass or other diseases. The etiologies in the acute hepatitis group in decreasing order of prevalence were hepatitis A (44.3%), toxic hepatitis (32.4%), other hepatitis viruses (13.8%), and cryptogenic hepatitis (9.1%). In the chronic hepatitis group, 51.2% of cases were attributed to viral hepatitis, 33.3% to nonalcoholic fatty liver disease, and 13.0% to alcoholic liver disease (ALD). Of the cirrhoses, 73.4% were attributable to viral causes and 18.1% to alcohol. Of the hepatocellular carcinoma cases, 86.6% were attributed to viral hepatitis and 11.6% to ALD. Among the benign tumors, hemangioma comprised 52.2% and cystic liver disease comprised 33.7%.

Conclusions: Knowledge of the current status of the type and cause of liver disease in Korea may be valuable as a basis for evaluating changing trends in liver disease in that country.

Keywords: Diagnosis; Etiology, Korea; Liver disease.

Figure 1

The prevalence of liver disease types. Chronic hepatitis was the most common type of liver disease in this cohort, comprising 62.7% of the liver diseases, followed by liver cirrhosis (12.2%), acute hepatitis (8.4%), primary liver cancer (8.1%), other benign disease (8.1%), and metastatic liver cancer (0.6%).

Figure 2

Overall causes of chronic liver disease. The viral cause of chronic liver disease progressively increased from chronic hepatitis to cirrhosis, and finally to hepatocellular carcinoma (HCC; 51.2%, 73.4%, and 86.6%, respectively), while that of nonalcoholic fatty liver disease (NAFLD) progressively decreased in the same order (33.3%, 6.6%, and 1.8%, respectively). HCC, hepatocellular carcinoma; NAFLD, nonalcoholic fatty liver disease.

Figure 3

The cause of acute hepatitis. The main etiologies of acute hepatitis were hepatitis A virus (HAV; 44.3%), toxic hepatitis (32.4%), and HCV (6.4%); HAV and hepatitis C virus (HCV) were observed together in two patients, and HAV and hepatitis E virus (HEV) were observed together in six. HAV, hepatitis A virus; HBV, hepatitis B virus; EBV, Epstein-Barr virus.

Figure 4

Classification of chronic liver disease according to viral etiology. Among the causes of chronic viral hepatitis, HBV/HCV was the cause in 82.0%/17.5%, while in cirrhosis and HCC, HBV/HCV was the cause in 83.7%/15.5% and 74.9%/24.1% of cases, respectively. HCC, hepatocellular carcinoma; HBV, hepatitis B virus; HCV, hepatitis C virus.