A study on the etiology of cirrhosis of liver in adults living in the Hills of Himachal Pradesh, India.

Aim: Cirrhosis of the liver is an important cause of morbidity and mortality in India. Currently no study exists on the disease from Himachal Pradesh, India. The purpose of this study was to evaluate epidemiological data on the etiological profile of cirrhosis of the liver in adults in a tertiary care hospital in a northern hilly state of Western Himalayas.

Materials and Methods: A hospital based, cross sectional, observational study was conducted in the department of Medicine and Gastroenterology in a tertiary care centre of Himachal Pradesh, located in northern India from 1st June, 2012 to 31st May, 2013. In total, 178 patients who were diagnosed with cirrhosis on the basis of history, physical examination, biochemistry and radiology, and of age >18 years were included in the study. Detailed history, examination and investigations were carried out in each case as per protocol.

Results: Alcohol was the leading cause of cirrhosis in our study (62.9%), hepatitis B was the second(10.1%), Non-Alcoholic Steatohepatitis (NASH) was the third (7.9%), and autoimmune the fourth (3.9%) most common cause for cirrhosis. Hepatitis C was present in 2.8% of patients as a cause of cirrhosis. Wilson disease and cardiac cirrhosis were present in one patient each. In 9.6% the etiology was cryptogenic.

Conclusion: The study identified alcohol as the leading cause of cirrhosis among people in the state. Measures for taking care of preventable risk factors are desired.