Chronic liver disease in Sri Lanka: cirrhosis and its complications

Abstract

The predominant cause of chronic liver disease in Sri Lanka is alcoholic cirrhosis (AC) and cryptogenic cirrhosis (CC). The latter is probably due to non-alcoholic steatohepatitis (NASH). With increasing incidence and prevalence of non-alcoholic fatty liver disease (NAFLD), NASH related cirrhosis will likely become the leading cause of chronic liver disease in Sri Lanka. The prevalence of chronic hepatitis B and hepatitis C is very low in the community, as well as among ‘high risk’ populations such as prisoners and those with transfusion dependent anaemia. This has led to a unique population of non-viral chronic liver disease patient population predominating in our country, which is a contrast to the rest of the South Asian region. In fact NAFLD is the leading cause for listing for liver transplantation and is the leading liver disease among potential liver donors for living donor liver transplantation. The long term transplant free survival of AC and CC patients is similar and death in both groups is predominantly liver related. We have also studied and published on hepatocellular carcinoma and chronic kidney disease in cirrhosis, minimal hepatic encephalopathy and road traffic collisions and the quality of life in cirrhosis.