Etiological Profile of Cirrhosis in a Hilly State of North India

Abstract

Aim: The etiological profile of cirrhosis is changing across India. Alcohol is now being reported as the most common cause of cirrhosis in India. The other common etiologies include viral (hepatitis b and c), autoimmune, nonalcoholic fatty liver disease (NAFLD) and metabolic causes. There is paucity of data regarding the etiology of cirrhosis from the hilly areas of North India. Materials andMethods: In this prospective observation study, from 1st June 2012 to 31st May 2013, all consecutive patients diagnosed with cirrhosis were included. Cirrhosis was diagnosed on the basis of imaging, Biochemical parameters and presence of varices on endoscopy. A detailed history, clinical examination and etiological evaluation were carried out. Results: A total of 178 patients were evaluated. Among these the most common etiology was alcohol (62.9%) followed by hepatitis B (10.1%), NAFLD (7.9%) and autoimmune (3.9%). Hepatitis C was the etiology in only 2.8% of patients. Wilson disease and cardiac cirrhosis were seen in one patient each respectively. In addition in 9.6% of patients were cryptogenic. Majority of the patients presented in advanced stages. At presentation the Child-Turcotte-Pugh stage A, B and C were seen in 12 (6.7%), 56 (31.4%) and 110 (61.8%) respectively. Ascites was the main complain in 160 pts (89.8) followed by Hepatic Encephalopathy of different Grades in 124 pt (69.7%) GI bleed in 48 pts (27%). Conclusion: Alcohol is the most common cause of cirrhosis in the hilly areas of North India. Most of the patients present with advanced liver disease. Ascites is the most common presentation.