Study of liver cirrhosis over ten consecutive years in Southern China

Table 1 Criteria for the etiological diagnosis of liver cirrhosis

Viral hepatitis

Hepatitis B virus (HBV): positive for HBsAg for at least 6 mo

Hepatitis C virus (HCV): positive for anti-HCV or HCV-RNA

HBV + HCV: HBV overlap with HCV

HBV + Hepatitis D virus (HDV): positive for HBsAg and anti-HDV

Alcoholic cirrhosis

The diagnosis was made by a history of alcohol use ( ≥ 40 g/d for males and ≥ 20 g/d for females or > 80 g/d within past 2 wk), physical examinations for signs of chronic liver disease, laboratory abnormalities [including elevation of aspartate aminotransferase, alanine aminotransferase, γ-glutamyl transferase (GGT) and prothrombin time] or typical imaging features of fatty liver and cirrhosis and the exclusion of other causes of LC[10]

Autoimmune diseases

Autoimmune hepatitis (AIH)[11]

Primary biliary cirrhosis (PBC)[12]

AIH + PBC: AIH and PBC overlap syndrome

Primary sclerosing cholangitis[13]

Secondary biliary cirrhosis

Established when compatible with the diagnosis of liver cirrhosis, excluding some common causes of LC and indicated by cholestatic biomarkers (such as elevated alkaline phosphatase and GGT)

Metabolic diseases

Wilson’s disease[14]

Hereditary hemochromatosis[15]

Non-alcoholic fatty liver disease[16]

Others (amyloidosis, glycogen storage disease, etc.)

Drugs

Established when the liver function test abnormalities related to drug intake and other causes of LC were excluded[17]

Vascular diseases

Budd-Chiari syndrome[18]

Cardiac[19]

Parasite cirrhosis

The diagnosis was based on clinical manifestations, epidemiologic features, and lab tests, excluding other types of LC; the diagnosis needed to be verified by a positive pathogenic finding

Infantile hepatitis syndrome

The diagnosis was based on criteria of Roberts[20]

Mixed etiology

HBV + Alcohol

HBV + HCV + Alcohol

Other known etiology

Cases with a definite known etiology but not listed above

Cryptogenic cirrhosis

Diagnosed only after an extensive evaluation excluded recognizable etiologies[21]