Aetiologies of Liver Cirrhosis among Adult Patients attending a Hepatology Clinic at Selangor, Malaysia

Abstract

Introduction: Liver cirrhosis is an important cause of morbidity and mortality.

Methods: Our study aimed to describe the clinical pattern of cirrhosis and its associated factors among adult patients attending Hepatology Clinic, Serdang Hospital, Malaysia from 1^st January 2010 to 30^th June 2017. Aetiology was further determined by history, biochemistry and/or histology. The severity of the cirrhosis, together with the presence of complications and incidence of hepatocellular carcinoma were documented.

Results: A total of 357 adult patients were diagnosed with cirrhosis including 199 male patients (55.7%) and 158 female patients (44.3%), with a mean age of 54-year-old (range: 28–84 –year-old). The causes of cirrhosis were chronic hepatitis B (N=145, 40.6%), chronic hepatitis C (N= 67, 18.8%), cryptogenic liver disorder (N= 63, 17.6%), alcohol (N=42, 11.8%), non-alcoholic fatty liver disease (N=25, 7.0%), and others (N=15, 4.2%). Chronic hepatitis B was the predominant aetiology among Chinese whereas alcohol was the main aetiology among Indians, and Hepatitis C cirrhosis was highest among Malays. Majority of the patients had compensated cirrhosis with Child-Pugh A (N=221, 61.9%) at the time of diagnosis. 80.4% (N=287) of the cirrhotic patients had performed at least one endoscopy surveillance, with 28.6% (82/287) of them had endoscopic evidence of portal hypertension. 32.2% of patients had at least one hospitalization due to complication of cirrhosis. 41 patients (11.5%) had concurrent hepatocellular carcinoma during the follow up.

Conclusions: Despite universal hepatitis B vaccination, Hepatitis B viral infection remains the most common cause of cirrhosis among patients attending Hepatology Clinic, Serdang Hospital.

Keywords: Aetiology - Liver cirrhosis - Malaysia