24. Epidemiology and prevention of hepatic cirrhosis

Epidemiology
- 0,02% prevalence
- 10th leading cause of death for men
- 10-year mortality: 50%
- Men > women
- In developed countries – mostly due to alcohol, non-alcoholic fatty liver disease
- In developing countries – mostly due to HBV, HCV, aflatoxin
Etiology
- Alcohol liver disease
  - 70% of cases
  - 40 – 80g/day for 20 years
  - Especially large amounts occasionally
- HBV
- HCV
- Non-alcoholic fatty liver disease
  - Obesity
  - Diabetes type 2
- Aflatoxin
- Alpha-1 antitrypsin deficiency
Prognosis
- Good in compensated cirrhosis
- Poor in decompensated cirrhosis
Prevention
- Primary
  - Prevention of alcohol abuse
  - HBV vaccination
  - Needle exchange programme – give clean needles to IV drug users
  - Safe sex
  - Promote healthy diet
- Secondary
  - Screen high-risk groups
- Tertiary
  - Treat underlying disease
  - Prevention of complication