Abstract
In Japan, preventive measures and antiviral therapy against acute or chronic viral infection had achieved remarkable progress in the 1980s or later. On the contrary, metabolic syndrome complicated with fatty liver has emerged as a public health concern to date.In the current study, we attempted to clarify etiological changes in liver cirrhosis treated in a single tertiary institute in Sapporo, Japan, from 1998 to 2016.Medical records of 1,166 patients (787 males, with mean of 64.9 ± 11.7 years), diagnosed as having liver cirrhosis for 19 years, were retrospectively reviewed to analyze etiology and clinical features.During the past 10 years, annual numbers of cirrhotic patients with chronic infection of hepatitis B virus (HBV) or hepatitis C virus (HCV) decreased from 50 or more to 20 or less, and alcoholic liver disease or cryptogenic liver injury emerged as major cause of liver cirrhosis. Among 100 cirrhotic patients of unknown cause, nonalcoholic fatty liver disease (NAFLD) occupied almost 50% in 19 observational years.In order to control the rising trend in NAFLD related with metabolic syndrome, preventive measures including education in society would be required in Japan.How to cite this article: Kang J-H, Matsui T. Changing Etiology in Liver Cirrhosis in Sapporo, Japan. Euroasian J Hepato-Gastroenterol 2018;8(1):77-80.
Highlights
Liver cirrhosis is regarded as the end stage for all chronic liver diseases regardless of their etiologies
Complication of hepatocellular carcinoma (HCC) was associated with infection of hepatitis C virus (HCV) in 47.4%, hepatitis B virus (HBV) in 25.1%, and related with alcoholic liver disease in 17.3%
Out of 607 patients with HCC, 53 (8.7%) cases had no relationship with infection of hepatotropic viruses, alcoholic liver cirrhosis, and autoimmune chronic liver diseases (Graph 2B)
Summary
Liver cirrhosis is regarded as the end stage for all chronic liver diseases regardless of their etiologies. In Japan, the numbers of patients with chronic viral hepatitis have obviously decreased in the new century because of preventive measures performed in the last two decades of the 20th century, such as vaccination and passive immune treatment in fetus against vertical transmission of HBV since 1988, eradication of contamination with viruses in blood products, establishment of single use, or adequate disinfection of medical instruments against horizontal transmission of HCV after the 1990s. On the contrary, shifting lifestyles on eating and exercise habits have prompted increment of metabolic disorders including fatty liver diseases related with or without excessive alcohol consumption. We tried to look for upcoming etiological shift in liver cirrhosis in the society concerned
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