Current trends of liver cirrhosis in Mexico: Similitudes and differences with other world regions

Abstract

Aim: To investigate the main current etiologies of cirrhosis in Mexico.

Methods: We performed a cross-sectional retrospective multicenter study that included eight hospitals in different areas of Mexico. These hospitals provide health care to people of diverse social classes. The inclusion criteria were a histological, clinical, biochemical, endoscopic, or imaging diagnosis of liver cirrhosis. Data were obtained during a 5-year period (January 2012-December 2017).

Results: A total of 1210 patients were included. The mean age was 62.5 years (SD = 12.1), and the percentages of men and women were similar (52.0% vs 48.0%). The most frequent causes of liver cirrhosis were hepatitis C virus (HCV) (36.2%), alcoholic liver disease (ALD) (31.2%), and nonalcoholic steatohepatitis (23.2%), and the least frequent were hepatitis B virus (1.1%), autoimmune disorders (7.3%), and other conditions (1.0%).

Conclusion: HCV and ALD are the most frequent causes of cirrhosis in Mexico. However, we note that non-alcoholic fatty liver disease (NAFLD) as an etiology of cirrhosis increased by 100% compared with the rate noted previously. We conclude that NAFLD will soon become one of the most frequent etiologies of liver cirrhosis in Mexico.

Keywords: Alcoholic liver disease; Hepatitis C virus; Liver cirrhosis; Nonalcoholic steatohepatitis.

Figure 1

Main etiologies by age group were alcoholic liver disease (n = 377), nonalcoholic steatohepatitis (n = 281), and hepatitis C virus (n = 438). The percentage of these etiologies was higher for patients aged 61-70 years (32.6%, 38.8%, and 38.6%, respectively). However, no significant differences in etiology were found between age groups (P = 0.166). HCV: Hepatitis C virus; NASH: Nonalcoholic steatohepatitis.

Figure 2

Changes in the epidemiology of liver cirrhosis in different countries reflect differences in etiologies, such as alcohol abuse and hepatitis B virus and hepatitis C virus infection. However, non-alcoholic fatty liver disease and its progressive form nonalcoholic steatohepatitis are becoming the most frequent etiologies of liver cirrhosis in Western countries. ALD: Alcoholic liver disease; HCV: Hepatitis C virus; HBV: Hepatitis B virus; NASH: Nonalcoholic steatohepatitis; NAFLD: Non-alcoholic fatty liver disease.