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Cirrhosis of the liver in Rhodesian Blacks
Insights
This study on Black patients with cirrhosis found high alcohol consumption from African beer but no Hepatitis B markers. The clinical presentation differed from typical alcoholic or cryptogenic cirrhosis.
Area of Science:
- Hepatology
- Internal Medicine
- Gastroenterology
Background:
- Cirrhosis of the liver is a significant health concern, particularly in specific populations.
- Understanding the etiological factors and clinical manifestations in Black patients with cirrhosis is crucial for targeted interventions.
Purpose of the Study:
- To investigate the clinical characteristics, etiological factors, and histological findings in Black patients diagnosed with cirrhosis.
- To compare alcohol consumption patterns and assess the prevalence of Hepatitis B infection markers in this cohort.
Main Methods:
- A prospective study was conducted over one year involving 35 Black patients admitted to a professorial unit.
- Data collected included patient demographics, alcohol intake (specifically African beer), clinical signs, and histological examination of liver biopsies.
- Hepatitis B surface antigen (HbsAg) testing was performed using a standard laboratory technique.
Main Results:
- Men predominated (3:1 ratio) among the 35 Black patients with cirrhosis.
- Significantly higher alcohol consumption, primarily African beer, was observed compared to controls.
- Common clinical features included hepatomegaly, porphyria cutanea tarda, ascites, splenomegaly, and esophageal varices, with a notable absence of gynaecomastia, spider nevi, and liver palms.
- Macronodular cirrhosis was the predominant histological finding; Hepatitis B surface antigen (HbsAg) was not detected in any patient.
Conclusions:
- Alcohol consumption, particularly African beer, is a significant factor in cirrhosis among Black patients studied.
- The clinical and histological profile of cirrhosis in this cohort differs from typical alcoholic or cryptogenic cirrhosis, and Hepatitis B is not a prevalent etiological factor.
- Further research is warranted to elucidate the specific causes and optimize management strategies for cirrhosis in Black populations.
Abstract:
Thirty-five Black patients with cirrhosis of the liver were admitted to the professorial unit over a 1-year period and were included in a carefully planned prospective study. Men predominated over women in a ratio of 3:1. Alcohol consumption in the form of African beer was significantly higher in cirrhotic patients than in a control population. The clinical picture was neither predominantly that of alcoholic nor of cryptogenic cirrhosis. Hepatomegaly, porphyria cutanea tarda, ascites, splenomegaly and oesophageal varices were common. There was a complete absence of gynaecomastia, spider naevi and liver palms. Histologically, the majority of patients had macronodular cirrhosis, and only 1 patient had micronodular cirrhosis and minimal fatty change. Hepatitis B surface antigen (HbsAg) was not detected in any patient, despite a positive HbAg rate of 4% in Black African blood donors, determined by means of the same laboratory technique.