Etiologic factors, diagnose and therapy of advanced liver cirrhosis in Albania compared with European data
Background and aims
There are no epidemiological data on severe liver cirrhosis in Albania. The aim of this study was to evaluate the role of etiological factors in Albanian patients with liver cirrhosis, admitted into the hospital in order to support indications on prevention and treatment according to current European guidelines
Methods
Data of patients consecutively admitted to the Department of Gastroenterology-Hepatology of University Medical Center of Tirana during 2019-2020 were evaluated.
Results
Of 120 patients enrolled, the reason of the hospital admission where: ascites in 19%, digestive bleeding in 4%, encephalopathy in 22%, HCC in 3%, the first diagnosis of liver cirrhosis due to liver failure in 24%, more than one complication in 28%. The liver damage’s etiology was: alcoholic in 56%, HBV in 18%, HCV in 7%, virus and alcohol in 12%, other in 7%. Of 11 patients with hepatocellular carcinoma 73% had HBV related cirrhosis. Of patients with HBV cirrhosis 19% were on tenofovir treatment (with no HBV DNA measurement) 34% reported previous lamivudine treatment without ongoing treatment, 47% reported no antiviral treatment. Of 13 patients HCV+, 70% were HCV-RNA+, of whom 23% relapse of antiviral treatment, 30% were HCV-RNA-.
Conclusions
Alcoholic abuse is the first cause of liver cirrhosis in Albania; this suggest the need to increase the population awareness for its prevention. HBV infection plays an important role in etiology of cirrhosis which urge an increasing HBV vaccination rate and an effective antiviral treatment. HCV infection should be screened in high-risk populations and once diagnosed, antiviral treatment should be offered independently of liver damage.
Keywords: Cirrhosis, Alcohol, HBV, HCV