Risk factors for osteoporosis in chronic liver diseases

Importance: Hepatic encephalopathy is a severe complication, and its contribution to clinical adverse outcomes in patients with acute-on-chronic liver diseases from the East is unclear.Objective: We aimed to investigate the impact of hepatic encephalopathy on clinical characteristics and adverse outcomes in prospective and multicenter cohorts of patients with acute-on-chronic liver diseases.Design: We conducted a cohort study of two multicenter prospective cohorts.Setting: China.Participants: Acute-on-chronic liver disease patients with various etiologies.Exposure: The diagnosis and severity of hepatic encephalopathy were assessed using the West Haven scale.Main Outcome Measure: The correlation between clinical adverse outcomes and varying hepatic encephalopathy grades was analyzed in the target patients.Results: A total of 3,949 patients were included, and 340 of them had hepatic encephalopathy. The incidence of hepatic encephalopathy was higher in patients with alcohol consumption (9.90%) than in those with hepatitis B virus infection (6.17%). The incidence of 28- and 90-day adverse outcomes increased progressively from hepatic encephalopathy grades 1–4. Logistic regression analysis revealed that hepatic encephalopathy grades 3 and 4 were independent risk factors for the 28- and 90-day adverse outcome in the fully adjusted model IV. Stratified analyses showed similar results in the different subgroups. Compared to grades 1–2 and patients without hepatic encephalopathy, those with grade 3 hepatic encephalopathy had a significant increase in clinical adverse outcomes, independent of other organ failures.Conclusions and Relevance: Hepatic encephalopathy grades 3–4 were independent risk factors for 28- and 90-day adverse outcomes. Hepatic encephalopathy grade 3 could be used as an indicator of brain failure in patients with acute-on-chronic liver disease.

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Pilot study of hepatitis b, c and human immunodeficiency viruses infections among patients with chronic liver diseases from north-east india attending a new tertiary care health set up at shillong

Indian Journal of Medical Sciences ◽

10.18203/issn.0019-5359.indianjmedsci20170485 ◽

2017 ◽

Vol 69 (1) ◽

pp. 18

Author(s):

Jeetendra Gurung ◽

Anil Chandra Phukan ◽

Annie B. Khyriem ◽

Kyrshanlang G. Lynrah

Keyword(s):

Public Health ◽

Risk Factors ◽

Hepatitis B ◽

Liver Diseases ◽

Hiv Infections ◽

Chronic Liver ◽

Chronic Liver Diseases ◽

North East India ◽

North East ◽

North Eastern

Background: Chronic liver diseases (CLD) are major public health concerns in North-Eastern India. Association of hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infections in CLD patients result in atypical presentations with increased severity and duration of illness. Understanding of agent, host, clinical profiles and their co-relationship for better management and prevention of such diseases in the community are important challenges. Aims: To assess sero-prevalance of HBV, HCV, HIV and their co-infection/triple infection in CLD patients from North-East India. To determine risk factors predisposing to development of CLDs. To find out if any correlation exists between risk factors for CLDs and that of HBV/HCV/HIV infections. Materials And Methods: This study was conducted from December 2009 to June 2011 in North-Eastern Indira Gandhi Regional Institute of Health and Medical Sciences. Blood samples were collected from 57 clinically diagnosed CLD patients after obtaining Institutional ethical clearance. Detail clinical profile with relevant biochemical test results were recorded. Viral markers - hepatitis B surface antigen, hepatitis B e (HBe) antigen, anti-HBe and anti-HCV were assessed employing commercial ELISA kits. Specimens were subjected for detection and confirmation of HIV infection as per NACO Guidelines. Results: Male to female ratio was 1.85:1 with most cases in range of 31-50 years. HBV markers were detected in 35 (61.40%) and anti-HCV in 2 (3.5%) patients. Anti-HIV was reactive in 7 (12.28%) patients; 4 co-infected with HBV and 2 with HCV. Conclusion: HBV is still a major cause of CLD, followed by HCV in North-East India. Co-infection of HBV/HCV with HIV was low (7.14%) in comparison to rest of India. Confections of HIV with HBV/HCV in CLDs patients was observed to be major public health concern in terms of risk factors and transmission dynamics of these chronic diseases in North-East India.<div> </div>

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