TRENDS OF CHRONIC LIVER DISEASES IN THE UNIVERSITY HOSPITAL, UANL FOR 25 YEARS. A SINGLE-CENTER EXPERIENCE

Abstract

Introduction and objectives: Liver cirrhosis is one of the main leading causes of death in Mexico. Some chronic liver diseases (CLD) are Alcoholic Liver Disease (ALD), Autoimmune Liver Disease (AILD), Hepatitis B (HBV), Hepatitis C (HCV), and Non-Alcoholic Steatohepatitis (NASH). In Mexico, ALD and HCV are the leading causes of CLD. Objective: To analyze the incidence of CLD in a liver unit (LU) over 25 years. Methods and materials: Clinical records of patients who attended for the first time to LU, from January 1995 to December 2019 were reviewed. There were 2780 patients with CLD, and 2668 filled the inclusion criteria with available clinical records. The diagnosis of CLD was made according to international guidelines. Inclusion criteria: patients with CLD in their first visit, with or without cirrhosis. Exclusion criteria: acute liver disease, <18 years old. Patients were divided by etiology. This study was observational, descriptive and the sampling was carried out in a non-probabilistic and convenient way. Intervals of time were group A (GA) 1995-2003, group B (GB) 2004-2011 and group C (GC) 2012-2019. A one-way ANOVA was used to determine the differences between these groups. Results: A statistically significant difference was found in the AILD, ALD and NASH groups, as determined by a one-way ANOVA (p=0.036, p=0.011 and p=<0.00). A Tukey post hoc test showed that AILD cases in GB were higher than GA (p=0.029). The same trend was observed in ALD cases, which also showed an increase between the GA and GC (p=0.012). For NASH cases, each period showed an increase (p=0.005AB, p=<0.001AC, p=0.013BC). HCV and HBV showed no statistically significant changes (Figure). Discussion: In Mexico, there is scarce information on the incidence of CLD. This study showed a higher NASH incidence (43%) than the previously reported (29%)1 as well as prevalence (23%)2 in cirrhotic patients. The incidence of HAI in this study was 17%, similar to a previous study of 16%1 in cirrhotic. Previously reported prevalence was 7.3%2 in cirrhotic patients. ALD incidence was 15%, previously reported in 23%1, and a prevalence of 31%2 in cirrhotic patients. HCV incidence had no significant changes (16%), but it was lower than previously reported (22%)1. Conclusions: This is the first study that reports an incidence of CLD in patients with or without cirrhosis. In the northeast of the country, the incidence of NASH has increased significantly during the last 25 years, becoming the most common CLD. This study found an AILD incidence similar to a previous report.1 ALD showed moderate elevation compared to NASH, and HCV began to decrease.The authors declare that there is no conflict of interest.