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
- Alcohol liver disease
- 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
- Primary