Aetiological and Histopathological correlates of liver cirrhosis in Nigeria

Abstract

Background and Objectives: Cirrhosis remains a major cause of morbidity and mortality in the world. It is the twelfth most common cause of death in the US. Viral aetiology is the most common cause in sub-Saharan Africa including Nigeria. Identification of cause could lead to formation of policies to tackle health problems as being done in countries like Taiwan and The Gambia with notable success. This paper aimed to determine the relative frequency of cirrhosis in liver biopsies received at the University College Hospital, Ibadan and to identify the aetiology where possible.
Methods: Liver biopsies entered in the surgical daybook of the Department of Pathology, University College Hospital, Ibadan between year 2000 and 2010 were listed for review. The slides and paraffin embedded blocks were retrieved and re-examined. The diagnoses were reviewed if found different from the initial sign-out. Cases were then classified according to pathological concept of disease present. Cases of cirrhosis were further evaluated.
Results: Two hundred and one liver biopsies were reviewed. Of these, 47 (23.4%) had cirrhosis. Thirteen (27.7%) out of the 47 were hepatocellular carcinoma with background cirrhosis, while 5 (10.6%) had biliary cirrhosis, 6 (12.8%) had cirrhosis with liver dysplasia and 23 (49.0%) had cirrhosis with or without chronic hepatitis. Hepatitis B viral aetiology was most probable in 7 cases, while features suggestive of Hepatitis C were seen in 2 cases. The male: female ratio was 2.5:1.
Conclusion: Hepatotrophic viral aetiology was the most common identified cause of liver cirrhosis in Ibadan. Hepatitis B virus remains a preventable infection of public health concern. Emphasis should be geared towards massive prevention programmes on a national scale. In infants, biliary cirrhosis was most common.

Keywords: Liver, cirrhosis, Hepatitis B, Hepatitis C