title: Epidemiological assessment of liver disease in northeastern Brazil by means of a standardized liver biopsy protocol.
abstract: OBJECTIVE
  The main objective of this study was to describe the profile of patients who were benefitted in a collective effort to perform liver biopsies in Bahia, Brazil.
  
  
  METHODS
  A cross-sectional study was conducted with a sample composed of all the patients who were submitted to liver biopsy during a collective effort carried out in Bahia between July 2007 and November 2009. At the time of the procedure, date on the age and gender of patients and the reason for performing the biopsy were recorded. Data on the degree of fibrosis and the presence of co-morbidities. Following statistical analysis, the frequency of the liver diseases that led to the biopsy procedure was described, and the profile of the patients was stratified into groups according to the most prevalent etiologies.
  
  
  RESULTS
  Of the 550 patients evaluated, 55.3% were men and 44.7% women. Mean age was 46.63 ± 11.59 years and there was no statistically significant difference in age between males and females. Of the 550 patients, 72% had hepatitis C and the mean age of these patients was 48.49 ± 10.1 years, significantly higher than the mean age of the patients with hepatitis B (40.41 ± 12.43 years). Furthermore, 70.7% of the patients with hepatitis C were between 41 and 60 years of age. The most frequent fibrosis grade was F2 (44%) and the prevalence of advanced fibrosis was 27.7%. Overall, 85 patients, most of them men, had some degree of iron overload. With respect to the safety of the biopsy procedure, severe complications occurred in only two patients.
  
  
  CONCLUSIONS
  Hepatitis C is the predominant liver disease that demanded liver biopsy. The profile of the patients who benefitted from this collective effort is similar to that of patients in the rest of the country. Moreover, non-Ultrasonography guided liver biopsy is safe and the collective effort to carry out liver biopsies in Bahia was found to be a viable venture.
authors.affiliation: Scientific Initiation Program of the Hepatology Unit, University Hospital, Federal University of Bahia, Salvador, Brazil.
authors.forename: Lucas
authors.initials: L
authors.lastname: Lembrança
authors.forename: Jéssica
authors.initials: J
authors.lastname: Medina
authors.forename: Marcelo
authors.initials: M
authors.lastname: Portugal
authors.forename: Delvone
authors.initials: D
authors.lastname: Almeida
authors.forename: Jorge
authors.initials: J
authors.lastname: Solla
authors.forename: Ricardo
authors.initials: R
authors.lastname: Gadelha
authors.forename: Luiz A R
authors.initials: LA
authors.lastname: de Freitas
authors.forename: Raymundo
authors.initials: R
authors.lastname: Paraná
mesh_terms: D000328:Adult; D001706:Biopsy / Q000009:adverse effects / Q000592:standards*; D001938:Brazil / Q000453:epidemiology; D016009:Chi-Square Distribution; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology / Q000473:pathology; D006526:Hepatitis C / Q000453:epidemiology / Q000473:pathology; D019693:Hepatitis, Autoimmune / Q000453:epidemiology / Q000473:pathology; D006801:Humans; D006975:Hypertension, Portal / Q000453:epidemiology / Q000473:pathology; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000453:epidemiology / Q000473:pathology; D008107:Liver Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012017:Referral and Consultation / Q000592:standards; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors