LIVER CIRRHOSIS IN MALAYSIA- PECULIAR EPIDEMIOLOGY IN A MULTIRACIAL ASIAN COUNTRY

March 31, 2011

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LIVER CIRRHOSIS IN MALAYSIA- PECULIAR EPIDEMIOLOGY IN A MULTIRACIAL ASIAN

COUNTRY

Choon Seng QUA MBBS (Monash), MRCP (UK), M Med (Mal) Senior Lecturer in

Medicine, Khean-Lee GOH MBBS (Mal), MD (Mal), FRCP (Glasgow,

London), FACG, FASGE Professor of Medicine

DOI: 10.1111/j.1440-1746.2011.06732.x

Publishing Asia Pty Ltd

Issue

Journal of Gastroenterology and Hepatology

Accepted Article (Accepted, unedited articles published online for future

issues)

Publication History

Author Information

Division of Gastroenterology and Hepatology, University of Malaya, Kuala Lumpur.

*Correspondence: Professor KL Goh Head of Gastroenterology and Hepatology

Department of Medicine Faculty of Medicine University of Malaya 50603 Kuala

Lumpur, Malaysia Fax: 603 79604190 E-mail: klgoh56@...

This is an Accepted Article that has been peer-reviewed and approved for

publication in the Journal of Gastroenterology and Hepatology, but has yet to

undergo copy-editing and proof correction. Please cite this article as an

“Accepted Article”; doi: 10.1111/j.1440-1746.2011.06732.x

ABSTRACT

Objectives To determine the etiology of liver cirrhosis and risk factors for

hepatocellular carcinoma (HCC) in a multiracial Asian population.

Methods Consecutive patients with liver cirrhosis presenting to outpatient

clinics and inpatient service at the University of Malaya Medical Centre from

1st April 2006 to 31th May 2009 were included.

Results 460 patients were included in the study: 317 male patients (68.9%) and

143 female patients (31.1%), with a mean age of 58.8 years (range: 15-87 years).

The major causes of cirrhosis were: chronic hepatitis B-n = 212, 46.1%, chronic

hepatitis C- n = 85, 18.5%, cryptogenic- n = 71, 15.4%, alcohol- n = 58, 12.6%,

autoimmune (n = 9, 2.0%). Alcohol was the main etiology in Indians (51.1%)

compared to Malay (0%) and Chinese (4.4%) (both p < 0.001). Hepatitis B was the

predominant etiology in Malay (47.9%) and Chinese (58.8%) compared to Indians

(5.6%) (both p < 0.001). Hepatitis C cirrhosis was highest in Malays (25.0%).

136 patients (29.6%) had concurrent HCC. Male sex (p < 0.001), age >60 years (p

= 0.014), hepatitis B (p < 0.001), hepatitis C (p = 0.006) and cryptogenic cause

(p = 0.002) were found to be independent risk factors for HCC.

Conclusions: The etiology of cirrhosis has a peculiar pattern based on racial

differences in alcohol intake and in the prevalence of hepatitis B.

March 31, 2011