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Etiologies of chronic liver diseases in Hong Kong
Konrad Tang-Tat Fung1, James Fung, Ching-Lung Lai
1Department of Medicine and Geriatrics, Kwong Wah Hospital, Hong Kong.
Insights
Chronic hepatitis B (CHB) is the leading cause of chronic liver disease (CLD) in Hong Kong, despite vaccination. Nonviral liver diseases like primary biliary cirrhosis (PBC) and nonalcoholic fatty liver disease are also significant concerns.
Area of Science:
- Hepatology
- Gastroenterology
- Public Health
Background:
- Chronic hepatitis B (CHB) is endemic in Hong Kong with an 8.8% prevalence.
- Limited data exists on chronic hepatitis C and other nonviral causes of chronic liver disease (CLD).
Purpose of the Study:
- To investigate the spectrum of CLDs in Hong Kong.
- To identify the underlying causes of CLD in the Hong Kong population.
Main Methods:
- Retrospective review of patient records from the Hepatology Clinic of Queen Mary Hospital, Hong Kong, in 2004.
- Identification of patients with CLD and their etiological classification.
Main Results:
- A total of 6106 CLD patients were identified.
- CHB was the most common cause (89.4%), followed by chronic hepatitis C (5.1%).
- Nonviral causes (5.5%) included alcoholic liver disease (1.7%), nonalcoholic fatty liver disease (1.5%), and primary biliary cirrhosis (1.3%).
Conclusions:
- CHB remains the predominant cause of CLD in Hong Kong, despite universal HBV vaccination.
- Primary biliary cirrhosis (PBC) and nonalcoholic fatty liver disease are significant nonviral causes in the Chinese population.
- Findings on chronic viral infections in PBC and alcoholic liver disease patients align with existing literature.
Background:
In Hong Kong, chronic hepatitis B (CHB) is endemic with a prevalence rate of 8.8%. Data, however, on chronic hepatitis C infection and other nonviral causes of chronic liver disease (CLD) are limited.
Aim:
To investigate the spectrum of CLDs in Hong Kong.
Methods:
Records of all patients attending the Hepatology Clinic of Queen Mary Hospital, Hong Kong, in 2004 were reviewed to identify those with CLDs and their underlying causes.
Results:
A total of 6106 patients were found to have CLD. CHB accounted for 89.4% of the cases, followed by chronic hepatitis C infection (5.1%). Nonviral causes accounted for the remaining 5.5% [alcoholic liver disease (ALD) (1.7%), nonalcoholic fatty liver disease (1.5%), primary biliary cirrhosis (PBC) (1.3%)]. Patients with CHB and Wilson's disease were significantly younger than patients with other causes (P<0.002). More than 90% of patients with autoimmune hepatitis and PBC were women. The prevalence of CHB infection was lower in patients with PBC than the general population. Among patients with ALD, the prevalence rate was higher for chronic hepatitis C but similar for CHB, as compared with the general population.
Conclusions:
Despite universal HBV vaccination since 1988, CHB remains the commonest cause of CLD in Hong Kong. PBC and nonalcoholic fatty liver disease were not rare in the Chinese population, being important causes of nonviral liver disease. The prevalence of chronic viral infection among patients with PBC or ALD confirmed the findings of other published literatures.
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