A paradigm shift in non-viral liver cirrhosis: a multicenter study on clinicoepidemiological characteristics and outcome of non-B non-C cirrhosis
Abstract Background Chronic hepatitis C (HCV) and B viruses (HBV) represent the commonest global causes of liver cirrhosis. Other etiologies of non-viral cirrhosis such as autoimmune, metabolic, vascular, or biliary diseases are underestimated. The study aimed to identify causes, clinicoepidemiologi...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2023-07-01
|
| Series: | Egyptian Liver Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43066-023-00270-y |
| _version_ | 1797779088835870720 |
|---|---|
| author | Haidi Karam-Allah Ramadan Fathiya El-Raey Samy Zaky Asmaa Bakr El-Zahraa M. Meghezel Shamardan Ezzeldin S. Bazeed Rehab Badawi Sherief Abd-Elsalam Mohamed Elbadry Mahmoud Hagag Mohamed Zakaria Abu Rahma |
| author_facet | Haidi Karam-Allah Ramadan Fathiya El-Raey Samy Zaky Asmaa Bakr El-Zahraa M. Meghezel Shamardan Ezzeldin S. Bazeed Rehab Badawi Sherief Abd-Elsalam Mohamed Elbadry Mahmoud Hagag Mohamed Zakaria Abu Rahma |
| author_sort | Haidi Karam-Allah Ramadan |
| collection | DOAJ |
| description | Abstract Background Chronic hepatitis C (HCV) and B viruses (HBV) represent the commonest global causes of liver cirrhosis. Other etiologies of non-viral cirrhosis such as autoimmune, metabolic, vascular, or biliary diseases are underestimated. The study aimed to identify causes, clinicoepidemiological characteristics, and outcome of non-B non-C liver cirrhosis. This Egyptian multicenter study recruited patients with liver cirrhosis excluding HCV and HBV. Clinical evaluation and the mortality were recorded. Laboratory, radiological, and histopathological assessment to diagnose the etiology was performed. Results One hundred eighty-eight patients were included: 54.3% were males. Autoimmune hepatitis (AIH) was the most common cause of cirrhosis (28.2%), followed by Budd-Chiari syndrome (BCS) in 25%, and cryptogenic in 23.9%. Metabolic causes such as Wilson’s disease, non-alcoholic steatohepatitis (NASH), and hemochromatosis were reported in 7.4%, 3.2%, and 1.1%, respectively. Biliary and cardiac cirrhosis were less frequent. Older age was prevalent in hemochromatosis (67.5 ± 17.7 years) and NASH (60.7 ± 11), while young age in Wilson’s disease (29.5 ± 14.8) and secondary biliary cirrhosis (14.8 ± 4.8). Rural residence was common (60.6%). Mortality was reported in BCS (40.4%), cryptogenic (28.9%), cardiac (25%), Wilson’s disease (21.4%), AIH (17%), and NASH (16.7%). Hepatocellular carcinoma complicated 10.6% of cases. A significantly high percentage of patients had decompensated cirrhosis. Child–Pugh class and rural residence were significant predictors of mortality. Conclusion This first report on non-B non-C cirrhosis in Egypt revealed a high prevalence of AIH, BCS, and cryptogenic cirrhosis. Advanced Child class and rural residence were the predictors of mortality. |
| first_indexed | 2024-03-12T23:25:44Z |
| format | Article |
| id | doaj.art-f980b6b55c174ee3a4272c9c42ea443c |
| institution | Directory Open Access Journal |
| issn | 2090-6226 |
| language | English |
| last_indexed | 2024-03-12T23:25:44Z |
| publishDate | 2023-07-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Egyptian Liver Journal |
| spelling | doaj.art-f980b6b55c174ee3a4272c9c42ea443c2023-07-16T11:10:05ZengSpringerOpenEgyptian Liver Journal2090-62262023-07-0113111010.1186/s43066-023-00270-yA paradigm shift in non-viral liver cirrhosis: a multicenter study on clinicoepidemiological characteristics and outcome of non-B non-C cirrhosisHaidi Karam-Allah Ramadan0Fathiya El-Raey1Samy Zaky2Asmaa Bakr3El-Zahraa M. Meghezel4Shamardan Ezzeldin S. Bazeed5Rehab Badawi6Sherief Abd-Elsalam7Mohamed Elbadry8Mahmoud Hagag9Mohamed Zakaria Abu Rahma10Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut UniversityDepartment of Hepatogastroenterology and Infectious Diseases, Faculty of Medicine, Al-Azhar UniversityDepartment of Hepatogastroenterology and Infectious Diseases, Faculty of Medicine, Al-Azhar UniversityDepartment of Hepatogastroenterology and Infectious Diseases, Faculty of Medicine, Al-Azhar UniversityDepartment of Tropical Medicine and Gastroenterology, Faculty of Medicine, Sohag UniversityDepartment of Tropical Medicine and Gastroenterology, Faculty of Medicine, South Valley UniversityDepartment of Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta UniversityDepartment of Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta UniversityDepartment of Endemic Medicine, Faculty of Medicine, Helwan UniversityDepartment of Gastroenterology and Hepatology, Ministry of HealthDepartment of Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut UniversityAbstract Background Chronic hepatitis C (HCV) and B viruses (HBV) represent the commonest global causes of liver cirrhosis. Other etiologies of non-viral cirrhosis such as autoimmune, metabolic, vascular, or biliary diseases are underestimated. The study aimed to identify causes, clinicoepidemiological characteristics, and outcome of non-B non-C liver cirrhosis. This Egyptian multicenter study recruited patients with liver cirrhosis excluding HCV and HBV. Clinical evaluation and the mortality were recorded. Laboratory, radiological, and histopathological assessment to diagnose the etiology was performed. Results One hundred eighty-eight patients were included: 54.3% were males. Autoimmune hepatitis (AIH) was the most common cause of cirrhosis (28.2%), followed by Budd-Chiari syndrome (BCS) in 25%, and cryptogenic in 23.9%. Metabolic causes such as Wilson’s disease, non-alcoholic steatohepatitis (NASH), and hemochromatosis were reported in 7.4%, 3.2%, and 1.1%, respectively. Biliary and cardiac cirrhosis were less frequent. Older age was prevalent in hemochromatosis (67.5 ± 17.7 years) and NASH (60.7 ± 11), while young age in Wilson’s disease (29.5 ± 14.8) and secondary biliary cirrhosis (14.8 ± 4.8). Rural residence was common (60.6%). Mortality was reported in BCS (40.4%), cryptogenic (28.9%), cardiac (25%), Wilson’s disease (21.4%), AIH (17%), and NASH (16.7%). Hepatocellular carcinoma complicated 10.6% of cases. A significantly high percentage of patients had decompensated cirrhosis. Child–Pugh class and rural residence were significant predictors of mortality. Conclusion This first report on non-B non-C cirrhosis in Egypt revealed a high prevalence of AIH, BCS, and cryptogenic cirrhosis. Advanced Child class and rural residence were the predictors of mortality.https://doi.org/10.1186/s43066-023-00270-yNon-B non-C cirrhosisNon-viral cirrhosisCryptogenicClinicoepidemiologicalMortality |
| spellingShingle | Haidi Karam-Allah Ramadan Fathiya El-Raey Samy Zaky Asmaa Bakr El-Zahraa M. Meghezel Shamardan Ezzeldin S. Bazeed Rehab Badawi Sherief Abd-Elsalam Mohamed Elbadry Mahmoud Hagag Mohamed Zakaria Abu Rahma A paradigm shift in non-viral liver cirrhosis: a multicenter study on clinicoepidemiological characteristics and outcome of non-B non-C cirrhosis Egyptian Liver Journal Non-B non-C cirrhosis Non-viral cirrhosis Cryptogenic Clinicoepidemiological Mortality |
| title | A paradigm shift in non-viral liver cirrhosis: a multicenter study on clinicoepidemiological characteristics and outcome of non-B non-C cirrhosis |
| title_full | A paradigm shift in non-viral liver cirrhosis: a multicenter study on clinicoepidemiological characteristics and outcome of non-B non-C cirrhosis |
| title_fullStr | A paradigm shift in non-viral liver cirrhosis: a multicenter study on clinicoepidemiological characteristics and outcome of non-B non-C cirrhosis |
| title_full_unstemmed | A paradigm shift in non-viral liver cirrhosis: a multicenter study on clinicoepidemiological characteristics and outcome of non-B non-C cirrhosis |
| title_short | A paradigm shift in non-viral liver cirrhosis: a multicenter study on clinicoepidemiological characteristics and outcome of non-B non-C cirrhosis |
| title_sort | paradigm shift in non viral liver cirrhosis a multicenter study on clinicoepidemiological characteristics and outcome of non b non c cirrhosis |
| topic | Non-B non-C cirrhosis Non-viral cirrhosis Cryptogenic Clinicoepidemiological Mortality |
| url | https://doi.org/10.1186/s43066-023-00270-y |
| work_keys_str_mv | AT haidikaramallahramadan aparadigmshiftinnonvirallivercirrhosisamulticenterstudyonclinicoepidemiologicalcharacteristicsandoutcomeofnonbnonccirrhosis AT fathiyaelraey aparadigmshiftinnonvirallivercirrhosisamulticenterstudyonclinicoepidemiologicalcharacteristicsandoutcomeofnonbnonccirrhosis AT samyzaky aparadigmshiftinnonvirallivercirrhosisamulticenterstudyonclinicoepidemiologicalcharacteristicsandoutcomeofnonbnonccirrhosis AT asmaabakr aparadigmshiftinnonvirallivercirrhosisamulticenterstudyonclinicoepidemiologicalcharacteristicsandoutcomeofnonbnonccirrhosis AT elzahraammeghezel aparadigmshiftinnonvirallivercirrhosisamulticenterstudyonclinicoepidemiologicalcharacteristicsandoutcomeofnonbnonccirrhosis AT shamardanezzeldinsbazeed aparadigmshiftinnonvirallivercirrhosisamulticenterstudyonclinicoepidemiologicalcharacteristicsandoutcomeofnonbnonccirrhosis AT rehabbadawi aparadigmshiftinnonvirallivercirrhosisamulticenterstudyonclinicoepidemiologicalcharacteristicsandoutcomeofnonbnonccirrhosis AT sheriefabdelsalam aparadigmshiftinnonvirallivercirrhosisamulticenterstudyonclinicoepidemiologicalcharacteristicsandoutcomeofnonbnonccirrhosis AT mohamedelbadry aparadigmshiftinnonvirallivercirrhosisamulticenterstudyonclinicoepidemiologicalcharacteristicsandoutcomeofnonbnonccirrhosis AT mahmoudhagag aparadigmshiftinnonvirallivercirrhosisamulticenterstudyonclinicoepidemiologicalcharacteristicsandoutcomeofnonbnonccirrhosis AT mohamedzakariaaburahma aparadigmshiftinnonvirallivercirrhosisamulticenterstudyonclinicoepidemiologicalcharacteristicsandoutcomeofnonbnonccirrhosis AT haidikaramallahramadan paradigmshiftinnonvirallivercirrhosisamulticenterstudyonclinicoepidemiologicalcharacteristicsandoutcomeofnonbnonccirrhosis AT fathiyaelraey paradigmshiftinnonvirallivercirrhosisamulticenterstudyonclinicoepidemiologicalcharacteristicsandoutcomeofnonbnonccirrhosis AT samyzaky paradigmshiftinnonvirallivercirrhosisamulticenterstudyonclinicoepidemiologicalcharacteristicsandoutcomeofnonbnonccirrhosis AT asmaabakr paradigmshiftinnonvirallivercirrhosisamulticenterstudyonclinicoepidemiologicalcharacteristicsandoutcomeofnonbnonccirrhosis AT elzahraammeghezel paradigmshiftinnonvirallivercirrhosisamulticenterstudyonclinicoepidemiologicalcharacteristicsandoutcomeofnonbnonccirrhosis AT shamardanezzeldinsbazeed paradigmshiftinnonvirallivercirrhosisamulticenterstudyonclinicoepidemiologicalcharacteristicsandoutcomeofnonbnonccirrhosis AT rehabbadawi paradigmshiftinnonvirallivercirrhosisamulticenterstudyonclinicoepidemiologicalcharacteristicsandoutcomeofnonbnonccirrhosis AT sheriefabdelsalam paradigmshiftinnonvirallivercirrhosisamulticenterstudyonclinicoepidemiologicalcharacteristicsandoutcomeofnonbnonccirrhosis AT mohamedelbadry paradigmshiftinnonvirallivercirrhosisamulticenterstudyonclinicoepidemiologicalcharacteristicsandoutcomeofnonbnonccirrhosis AT mahmoudhagag paradigmshiftinnonvirallivercirrhosisamulticenterstudyonclinicoepidemiologicalcharacteristicsandoutcomeofnonbnonccirrhosis AT mohamedzakariaaburahma paradigmshiftinnonvirallivercirrhosisamulticenterstudyonclinicoepidemiologicalcharacteristicsandoutcomeofnonbnonccirrhosis |