Clinical presentation and magnitude of hepatitis B infection among patients with liver cirrhosis attending Muhimbili National Hospital

Abstract

Background: Chronic liver disease is responsible for over 1.4 million deaths annually. In the western world this disease is among the top ten of disease-related causes of death. The World Health Organization (WHO) estimates that in 2002 liver cirrhosis and primary liver cancer caused 783,000 and 619,000 deaths, respectively. Taken together, these conditions represented approximately one of every forty deaths (2.5%) worldwide. In Tanzania liver cirrhosis is one of the leading diseases among the liver disorders. Although major causes of liver cirrhosis varies in different regions of the world, but overall hepatitis B virus remain the commonest cause of liver cirrhosis worldwide. In Tanzania very little has been published on liver cirrhosis and no studies done regarding clinical presentation and the magnitude of HBV infection among patients with liver cirrhosis. Scarcity of information on the extent of this problem in our set up may halt the effort to prevent, timely diagnose and give better care to our patients with liver cirrhosis. Objective The main objective of this study was to describe the clinical presentations and determine the magnitude of Hepatitis B viral infection among patients with liver cirrhosis attended Muhimbili National Hospital Tanzania (MNH).

Methods The study design was hospital based descriptive study, which was conducted in the surgical and medical Gastroenterology units, starting from July 2012 to February 2013. Results Out of the 81 liver cirrhotic patients 60(74%) were males. Ascites (92%) was the commonest clininical presentation, followed by lower limb edema (56%). Other stigmatas of chronic liver disease such as dupyutrens contracture, spider naevi and caput medusa were seen in minority of patients. Prevalence of HBsAg was found to be 48% among patients with liver cirrhosis. Large proportion of patients had MELD score of 19 and below.

Conclusion: Liver cirrhosis is more common in males. Mean age of patients with liver cirrhosis in this study is 39±14.582 years. Prevalence of HBsAg among patients with liver cirrhosis in this study is high (48%). Majority of patients with liver cirrhosis in this study present to the hospital with very advanced decompensated liver cirrhosis. Large proportion (84%) of patients with liver cirrhosis in this study had low MELD score.