Cirrhosis etiology trends in developing countries: Transition from infectious to metabolic conditions. Report from a multicentric cohort in central Mexico

The Lancet Regional Health. Americas

Ana K. Valenzuela-Vidales¹  Antonio Olivas-Martinez²  Maria Sarai Gonzalez-Huezo³  Guadalupe Milanés-Lizarraga³  Orestes de Jesús Cobos-Quevedo⁴  Mauricio Castillo-Barradas⁴  Oscar Juárez-León⁵  Alex Gonzalez-Chagolla⁵  Luis Carlos Chávez-García⁵  Jesus Ruiz-Manriquez⁵  Eric Kauffman-Ortega⁵  Francisco Isaí García-Juárez⁶  José Alberto Romero-Lozanía⁶  Ignacio García-Juárez⁷  Isaac Ruiz⁸  Juan Daniel Díaz-García⁹  José Alonso Avila-Rojo^1,10  Aliberth Bonilla-Salas^1,11  Juan Francisco Sánchez-Avila^1,12  Jacqueline Cordova-Gallardo^1,13  Maximiliano Servín-Rojas^1,14  Liz Toapanta-Yanchapaxi^1,15  Victor M Paez-Zayas^1,16  Michelle Dirthurbide-Hernández^1,17 

[1] Institut Mondor de Recherche Biomédicale (IMRB), INSERM U955 Team 18, Hôpital Henri Mondor, Université Paris-Est, Créteil, France;Department of Biostatistics, University of Washington, Seattle, WA, United States;Department of Gastroenterology, Centro Médico ISSEMYM, Toluca, State of Mexico, Mexico;Department of Gastroenterology, Hospital de Especialidades Dr Antonio Fraga Mouret Centro Médico Nacional La Raza IMSS, Mexico City, Mexico;Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico;Department of Gastroenterology. Hospital Regional Licenciado Adolfo López Mateos, Mexico City, Mexico;Department of Hematology-Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico;Department of Hepatology and Liver Transplantation, Centre Hospitalier de l'Université de Montréal (CHUM), Canada;Department of Internal Medicine, Hospital General Dr Manuel Gea Gonzalez,Mexico City, Mexico;Department of Internal Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico;Department of Surgery, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico;Escuela de Medicina y Ciencias de la Salud, Tecnológico de Monterrey, Nuevo León, Mexico;Hepatology clinic, Department of Surgery, Hospital General Dr Manuel Gea Gonzalez, Mexico City, Mexico;Liver transplant unit and department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Av. Vasco de Quiroga 15, colonia Belisario Domínguez Sección XVI, Tlalpan, Mexico City 14080, Mexico;Neuromuscular Disease Clinic, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico;Organ Transplant Department, Hospital General de Mexico Doctor Eduardo Liceaga, Mexico City, Mexico;School of Medicine, Universidad Autónoma del Estado de Morelos, Morelos, Mexico;

关键词: Cirrhosis;    MAFLD;    Hepatocellular carcinoma;    Hepatitis C Virus;    Alcohol liver disease;    Liver transplantation;   

DOI  :  

来源: DOAJ

【 摘 要 】

Summary:Background: Cirrhosis is a public health threat associated with high mortality. Alcoholic Liver Disease (ALD) is the leading cause in Latin America and Metabolic Associated Fatty Liver Disease (MAFLD) in western countries. In Mexico, ALD and chronic Hepatitis C Virus infection (HCV) were the most frequent aetiologies during the past decades. We aimed to describe the trends in the aetiologies of cirrhosis in a middle-income country. Methods: We performed a retrospective cohort study including patients diagnosed with cirrhosis between 2000 and 2019 from six different tertiary care hospitals in central Mexico. We collected information regarding cirrhosis etiology, year of diagnosis, hepatocellular carcinoma development, liver transplantation, and death. We illustrated the change in the tendencies of cirrhosis aetiologies by displaying the proportional incidence of each etiology over time stratified by age and gender, and we compared these proportions over time using chi square tests. Findings: Overall, 4,584 patients were included. In 2019, MAFLD was the most frequent cirrhosis etiology (30%), followed by ALD (24%) and HCV (23%). During the study period, MAFLD became the leading etiology, ALD remained second, and HCV passed from first to fourth. When analysed by gender, ALD was the leading etiology for men and MAFLD for women. The annual incidence of HCC was 3·84 cases/100 persons-year, the median survival after diagnosis was 12·1 years, and seven percent underwent LT. Interpretation: Increased alcohol consumption and the obesity epidemic have caused a transition in the aetiologies of cirrhosis in Mexico. Public health policies must be tailored accordingly to mitigate the burden of alcohol and metabolic conditions in developing countries. Funding: None.

【 授权许可】

Unknown