title: Etiology of liver cirrhosis in Brazil: chronic alcoholism and hepatitis viruses in liver cirrhosis diagnosed in the state of Espírito Santo.
abstract: OBJECTIVE
  To report the etiology of liver cirrhosis cases diagnosed at the University Hospital in Vitoria, Espirito Santo, Brazil.
  
  
  METHODS
  The medical charts of patients with liver cirrhosis who presented to the University Hospital in Vitoria were reviewed. Chronic alcoholism and the presence of hepatitis B or C infections (HBV and HCV, respectively) were pursued in all cases.
  
  
  RESULTS
  The sample consisted of 1,516 cases (male:female ratio 3.5:1, aged 53.2 ± 12.6 years). The following main etiological factors were observed: chronic alcoholism alone (39.7%), chronic alcoholism in association with HBV or HCV (16.1 %), HCV alone (14.5%) and in association with alcoholism (8.6%) (total, 23.1 %), and HBV alone (13.1%) and in association with alcoholism (7.5%, total 20.6%). The remaining etiologies included cryptogenic cases (9.8%) and other causes (6.0%). The mean patient age was lower and the male-to-female ratio was higher in the cirrhosis cases that were associated with alcoholism or HBV compared with other causes. Intravenous drug abuse and a history of surgery or blood transfusion were significantly associated with HCV infection. Hepatocellular carcinoma was present at the time of diagnosis in 15.4% of cases. Chronic alcoholism associated with HCV infection was significantly associated (p<0.001) with reduced age (at the time of cirrhosis diagnosis) and increased prevalence of hepatocellular carcinoma (p = 0.052).
  
  
  CONCLUSIONS
  Alcoholism, HCV and HBV are the main factors associated with liver cirrhosis in the state of Espirito Santo. Chronic alcoholism associated with HCV infection reduced the age of patients at the time of liver cirrhosis diagnosis.
authors: Serviço de Gastroenterologia, Hospital Universitário Cassiano A Moraes, Universidade Federal do Espírito Santo, Vitória, ES, Brazil.
authors: Patricia Lofego
authors: PL
authors: Gonçalves
authors: Maria da Penha
authors: Mda P
authors: Zago-Gomes
authors: Carla Couzi
authors: CC
authors: Marques
authors: Ana Tereza
authors: AT
authors: Mendonça
authors: Carlos Sandoval
authors: CS
authors: Gonçalves
authors: Fausto Edmundo Lima
authors: FE
authors: Pereira
mesh_terms: D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000150:complications*; D001938:Brazil; D005260:Female; D006509:Hepatitis B / Q000150:complications*; D006526:Hepatitis C / Q000150:complications*; D006519:Hepatitis, Alcoholic; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D017678:Sex Distribution
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