Liver Cirrhosis, Etiology and Clinical Characteristics Disparities Among Minority Population

Abstract Background: Liver cirrhosis (LC) is a common disease with varied primary causes and ethnic disparities. We aimed to determine the frequency, clinical characteristics, and outcomes of LC among the Arab Bedouin (AB) population in southern Israel. Methods: This retrospective and follow-up study enrolled all patients diagnosed with LC at the gastroenterology and hepatology department or the internal medicine ward. Patient records were reviewed for demographic, clinical data, and mortality. Clinical primary outcomes were defined as death, hepatocellular carcinoma or liver transplantation. Results: We included 820 patients 69 (8.4%) AB and 752 (91.6%) Jewish patients. Incidence of cirrhosis found in our study was much lower among AB patients, 5-10/100,000/year, compared with 20-40/100,000 per year in Jewish patients. Age at diagnosis was 42.6±16.9 years among Bedouins compared to 61±13 years (p<0.001) among Jews. The study included 25 (36.2%) male AB and 472 (63%) male Jewish patients (p<0.001). The most frequent causes of LC among AB were cryptogenic (24.6%), hepatitis B (18.8%) and autoimmune hepatitis (17.4%), while hepatitis C (41.7%), fatty liver (16.5%) and alcoholic liver disease (15.5%) were most common among Jewish patients. An all-cause mortality of 41.8% was found in AB patients compared to 63.4% in Jewish patients (p<0.001). Primary clinical outcomes were found by 34 (49%) AB patients and by 510 (67.9%) Jewish patients (p=0.002), with 46 and 608 events, retrospectively. Conclusions: The incidence of liver cirrhosis among Arab Bedouin is lower than that in the Jewish population, with disparities in etiology, age at diagnosis, presence of complications and mortality.

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Liver Cirrhosis, Etiology and Clinical Characteristics Disparities among Minority Population

10.21203/rs.2.15257/v1 ◽

2019 ◽

Author(s):

Muhammad Abu Tailakh ◽

Liat Poupko ◽

Najwan Kayyal ◽

Alsana Ali ◽

Ohad Etzion ◽

...

Keyword(s):

Liver Cirrhosis ◽

Clinical Characteristics ◽

Ethnic Disparities ◽

Age At Diagnosis ◽

Common Disease ◽

Minority Population ◽

All Cause Mortality ◽

Complications And Mortality ◽

Ward Patient

Abstract Background Liver cirrhosis (LC) is a common disease with varied primary causes and ethnic disparities. We aimed to determine the frequency, clinical characteristics, and outcomes of liver cirrhosis among the Arabs population in southern Israel.Methods This retrospective and follow-up study enrolled all patients diagnosed with liver cirrhosis at the gastroenterology and hepatology department or the internal medicine ward. Patient records were reviewed for demographic, clinical data, and mortality. Clinical primary outcomes were defined as death, hepatocellular carcinoma or liver transplantation.Results We included 820 patients 69 (8.4%) Arabs and 752 (91.6%) Jewish patients. Incidence of cirrhosis was much lower among Arabs patients, 5-10/100,000/year, compared with 20-40/100,000 per year in Jewish patients. Age at diagnosis was 42.6±16.9 years among Bedouins compared to 61±13 years (p<0.001) among Jews. The study included 25 (36.2%) male Bedouins and 472 (63%) male Jews (p<0.001). The most frequent causes of liver cirrhosis among Arabs were cryptogenic (24.6%), hepatitis B (18.8%) and autoimmune hepatitis (17.4%), while hepatitis C (41.7%), fatty liver (16.5%) and alcoholic liver disease (15.5%) were most common among Jewish patients. An all-cause mortality of 41.8% was found in Arabs patients, compared to 63.4% in Jewish patients (p<0.001). Primary clinical outcomes were found by 34 (49%) Arabs patients and by 510 (67.9%) Jewish patients (p=0.002), with 46 and 608 events, retrospectively.Conclusions The incidence of liver cirrhosis among Arabs is lower than that in the Jewish population, with disparities in etiology, age at diagnosis, presence of complications and mortality.

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