Distinguishing between the complications of Wilson disease-related cirrhosis and HBV-related cirrhosis

Curr Med Res Opin. 2022 Jan;38(1):75-81. doi: 10.1080/03007995.2021.1993160. Epub 2021 Oct 24.

Abstract

Objective: Complications affect the outcome of patients with cirrhosis. The favorable prognosis of patients with Wilson disease (WD)-related cirrhosis suggests that its complications differ from those of hepatitis B virus (HBV) infection-related cirrhosis. We aimed to delineate the differences in complications between WD-related and HBV-related cirrhosis.

Methods: The electronic-medical data from patients with WD-related and HBV-related cirrhosis were extracted and analyzed.

Results: In total, 211 patients with WD-related cirrhosis and 374 patients with HBV-related cirrhosis were enrolled. Most patients with WD progressed to cirrhosis <10 years after disease onset, whereas those with HBV infection often progressed after >10 years. Patients with WD-related cirrhosis had a markedly lower prevalence of ascites (8.5% vs. 38.5%), gastroesophageal varices/variceal bleeding (13.3% vs. 47.6%), renal impairment (0 vs. 7.6%) and primary liver cancer (0 vs. 39.3%; all p < .001) than those with HBV-related cirrhosis. After adjustment for potential confounders, patients with WD-related cirrhosis carried a lower risk of varices/variceal bleeding.

Conclusions: Although patients with WD progressed to cirrhosis much faster, the prevalence of complications from WD-related cirrhosis was low. Patients with WD-related cirrhosis were less likely to develop gastroesophageal varices/variceal bleeding than those with HBV-related cirrhosis.

Keywords: Wilson disease; complications; hepatitis B; liver cirrhosis.

MeSH terms

  • Esophageal and Gastric Varices* / epidemiology
  • Esophageal and Gastric Varices* / etiology
  • Gastrointestinal Hemorrhage
  • Hepatitis B virus
  • Hepatolenticular Degeneration* / complications
  • Hepatolenticular Degeneration* / diagnosis
  • Hepatolenticular Degeneration* / epidemiology
  • Humans
  • Liver Cirrhosis / epidemiology
  • Liver Cirrhosis / etiology