Chronic liver disease is an important cause of morbidity and mortality, but the epidemiology is not well described.
Dr Beth Bell and colleagues from Georgia, USA conducted a prospective population-based surveillance to estimate newly diagnosed chronic liver disease incidence, characterize etiology distribution, and determine disease stage.
The team identified cases of chronic liver disease newly diagnosed during 1999 and 2001 among adult county residents seen in any gastroenterology practice in Oregon, and the Northern California Kaiser Permanente Medical Care Program.
The team defined chronic liver disease as abnormal liver tests of at least 6 months' duration or pathologic, clinical, or radiologic evidence of chronic liver disease.
Consenting patients were interviewed, a blood specimen obtained, and the medical record was reviewed.
|Men aged 45 to 54 years had the highest Hep C incidence rate|
|The American Journal of Gastroenterology |
The researchers identified 2353 patients with newly diagnosed chronic liver disease, reported as 64 cases per 100,000 population.
The research team identified 1225 Hepatitis C patients, reported as 33 cases per 100,000.
Men aged 45 to 54 years had the highest Hepatitis C incidence rate, at 111 per 100,000.
Among 1040 enrolled patients, the median age was 48 years.
The team found Hepatitis C, either alone or in combination with alcohol-related liver disease, accounted for 75% of the cases.
Other etiologies included nonalcoholic fatty liver disease, alcohol-related liver disease, and Hepatitis B.
Other identified etiologies each accounted for less than 3% of the cases.
A total of 18% of patients presented with cirrhosis, including 44% of patients with alcohol-related liver disease.
Dr Bell’s team concluded, “Extrapolating from this population-based surveillance network to the adult population in the USA, approximately 150,000 patients with chronic liver disease were diagnosed in gastroenterology practices each year during 1999 to 2001.”
“Most patients had Hepatitis C, and heavy alcohol consumption among these patients was common.”
“Almost 20% of patients, an estimated 30,000 per year, had cirrhosis at presentation.”
“These results provide population-level baseline data to evaluate trends in identification of patients with chronic liver disease in gastroenterology practices.”