24. Epidemiology and prevention of hepatic cirrhosis

From greek.doctor
  • 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