Burden of liver disease in Brazil

Nader, Lysandro Alsina; Mattos, Ângelo Alves de; Bastos, Gisele Alsina Nader

doi:10.1111/liv.12470

Cited by 45 publications

(40 citation statements)

References 18 publications

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“…However, there are very few studies that consider mortality from liver disease by aggregating death rates from different causes such as liv- er cirrhosis, liver cancer, viral hepatitis, and HBV/HCV coinfection with HIV. In this study, in which mortality from fourteen types of hepatobiliary disease was aggregated, the disease was found to be the 8th leading cause of death in Portugal, consistent with results from Europe [6] and Brazil [23].…”

Section: Discussionsupporting

confidence: 66%

Mortality Associated with Hepatobiliary Disease in Portugal between 2006 and 2012

Rocha

Marinho

Rodrigues

2017

GE Port J Gastroenterol

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Introduction: Hepatobiliary disease is becoming a major public health problem, and recent data suggest that the burden of liver disease is higher than previously thought. Our aim was to quantify the mortality from hepatobiliary disease in Portugal and to compare this with the mortality related to other causes over a 7-year period (2006-2012). Materials and Methods: A statistical analysis of mortality data according to cause, sex, age, and region from the National Statistics Institute in Portugal was carried out. The data related to 14 causes of death, the most frequent of which were alcoholic liver disease (ALD) (International Classification of Diseases code K70), unspecified cirrhosis of liver (UCL) (K74.6), hepatocellular carcinoma (HCC) (C22.0), unspecified malignant neoplasm of liver (C22.9), and cholangiocarcinoma (C22.1). Results: Between 2006 and 2012, 18,279 deaths (24.5/100,000) from hepatobiliary disease were registered in Portugal, constituting the 8th leading cause of death. The main causes of death from hepatobiliary disease were ALD (7.1/100,000), UCL (5.5/100,000), and HCC (4.3/100,000), with a male predominance (72%). ALD was the main aetiology in younger age groups (40-65 years), while primary neoplasms of the liver and the intrahepatic bile ducts were predominant in the elderly (>80 years). The mortality related to HCC increased by 66% between 2006 and 2012. Conclusion: These data outline the burden of hepatobiliary disease in Portugal (8th cause of death) and highlight a potential impact on economic productivity.

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Section: Discussionsupporting

confidence: 66%

Mortality Associated with Hepatobiliary Disease in Portugal between 2006 and 2012

Rocha

Marinho

Rodrigues

2017

GE Port J Gastroenterol

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“…According to data from the Brazilian Unified Health System, between 2001 and 2010, liver diseases were the eighth leading cause of death in Brazil [1] . Cirrhosis was the main cause of hospital admissions and death from liver disease in Brazil, especially in the South region of the country.…”

Section: General Considerationsmentioning

confidence: 99%

Cirrhosis in children and adolescents: An overview

Pinto

Schneider

Silveira

2015

WJH

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Several conditions, especially chronic liver diseases, can lead to cirrhosis in children and adolescents. Most cases in clinical practice are caused by similar etiologies. In infants, cirrhosis is most often caused by biliary atresia and genetic-metabolic diseases, while in older children, it tends to result from autoimmune hepatitis, Wilson's disease, alpha-1-antitrypsin deficiency and primary sclerosing cholangitis. The symptoms of cirrhosis in children and adolescents are similar to those of adults. However, in pediatric patients, the first sign of cirrhosis is often poor weight gain. The complications of pediatric cirrhosis are similar to those observed in adult patients, and include gastrointestinal bleeding caused by gastroesophageal varices, ascites and spontaneous bacterial peritonitis. In pediatric patients, special attention should be paid to the nutritional alterations caused by cirrhosis, since children and adolescents have higher nutritional requirements for growth and development. Children and adolescents with chronic cholestasis are at risk for several nutritional deficiencies. Malnutrition can have severe consequences for both pre-and post-liver transplant patients. The treatment of cirrhosis-induced portal hypertension in children and adolescents is mostly based on methods developed for adults. The present article will review the diagnostic and differential diagnostic aspects of end-stage liver disease in children, as well as the major treatment options for this condition.

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“…In Brazil, liver disease is the eighth cause of death, being cirrhosis and liver cancer the most common of these. 6 …”

Section: Introductionmentioning

confidence: 99%

Alpha-fetoprotein Level Predicts Recurrence After Transplantation in Hepatocellular Carcinoma

et al. 2016

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Hepatocellular carcinoma (HCC) is one of the leading causes of liver transplantation. In an attempt to predict their recurrence after liver transplantation, evaluation of tumor number and size, degree of histologic differentiation, and the presence of vascular invasion already have their importance established. In this context, the role of biologic markers such as alpha-fetoprotein (AFP) is still not clear. This retrospective cross-sectional study analyzed the AFP relationship with recurrence of HCC after orthotopic liver transplantation.The current study retrospectively analyzed data from 206 patients with a histopathologic confirmed HCC between 1997 and 2010.The overall survival rates at 1, 3, 5, and 14 years were 78.6%, 65.4%, 60.5%, and 38.7%, respectively. The frequency of recurrence was 15.5%, and recurrence was significantly associated with a lower survival rate (P < 0.001). No association was observed between survival and AFP level (P = 0.153). A correlation, however, was found between tumor recurrence and AFP level (P = 0.002). Univariate analysis of risk factors for recurrence revealed that an AFP level greater than 200 ng/mL, the number of tumors, the degree of cellular differentiation, and the presence of vascular invasion or satellite nodules were associated with relapse. By multivariate analysis, only an AFP level greater than 200 ng/mL remained as a risk factor.Although an elevated AFP level did not correlate with survival in HCC patients undergoing orthotopic liver transplantation, a high AFP level was associated with a 3.32-folds increase in the probability of HCC recurrence.

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Burden of liver disease in Brazil

Abstract: This study provides evidence of the relevance of liver diseases within the framework of the Brazilian Unified Health System, and shows that the burden of these diseases is not only significant but progressive, at least in terms of hospital admissions and mortality rate.

Cited by 45 publications

References 18 publications

Mortality Associated with Hepatobiliary Disease in Portugal between 2006 and 2012

Mortality Associated with Hepatobiliary Disease in Portugal between 2006 and 2012

Cirrhosis in children and adolescents: An overview

Alpha-fetoprotein Level Predicts Recurrence After Transplantation in Hepatocellular Carcinoma

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