Etiological spectrum of liver cirrhosis in the Chinese

Abstract

A combined prospective-retrospective hospital study for the etiological spectrum of non-hepatomatous liver cirrhosis in the Chinese in Hong Kong was performed on a total of 731 patients. In the prospective part, the three commonest causes of liver cirrhosis in the population were found to be chronic active type-B hepatitis, alcoholic liver disease and cryptogenic cirrhosis. In the retrospective analysis, before tests for HBsAg were available, the commonest cause was cryptogenic cirrhosis. Of 60 patients who had previously been so diagnosed and were re-studied prospectively later, 50 were found to have chronic active type-B hepatitis. The frequency of this disease showed no sign of falling between the years 1962 and 1976. Alcoholic liver disease was increasingly more common ( χ 2 = 14.3, p < 0.001). The rising frequency of alcoholic cirrhosis between 1962 and 1976 approximated the average per capita expenditure on alcoholic drink in the community during the same period. Although there was an increasing tendency to take Western liquors, consumers of Chinese wines currently still accounted for 75% of those who had steady alcoholic intake. Haemochromatosis was the cause of cirrhosis in only one out of the 731 patients. We concluded: (1) that hepatitis B virus infection was the most important cause of liver cirrhosis in the Chinese in Hong Kong, and this importance was undiminished over the last 15 yr, (2) that alcoholism was an increasingly important cause of liver cirrhosis in our increasingly affluent and ‘Westernised’ society, and (3) that the majority of patients previously labelled as having ‘cryptogenic’ postnecrotic cirrhosis were suffering from hepatitis B virus infection and, therefore, former metabolic data on liver cirrhosis published from this Department dominantly applied to HBsAg-positive cirrhosis.