# Hospital admissions for chronic liver diseases: a temporal study in the South Region of Brazil

## TL;DR

Hospital admissions for liver diseases in Brazil shifted from viral hepatitis to nonalcoholic fatty liver disease and autoimmune conditions between 2014–2017 and 2019–2022.

## Contribution

The study reveals a significant epidemiological shift in liver disease admissions in a Brazilian hospital over time.

## Key findings

- Hepatitis C was the leading cause of admission in 2014–2017, but nonalcoholic fatty liver disease became most common in 2019–2022.
- Viral hepatitis prevalence decreased significantly for both males and females, while autoimmune liver diseases increased only in males.
- Ascites remained the most prevalent complication in both study periods.

## Abstract

The aim of the study was to compare the epidemiology and clinical profiles of hospital admissions in a single Brazilian Hepatology Unit from the period 2014–2017 to 2019–2022.

A retrospective analysis of hospital database from the abovementioned periods was done. The study included patients over the age of 18 years who were hospitalized due to complications of diseases such as viral hepatitis, alcoholic disease, nonalcoholic fatty liver disease, and autoimmune liver and drug-induced hepatitis.

In both study periods, middle-aged males were predominant and were younger than females. In the first period (2014–2017), hepatitis C (33.5%) was the most prevalent cause of admission, followed by alcoholic liver disease (31.7%). In the second period (2019–2022), nonalcoholic fatty liver disease (38%) and alcoholic liver disease (27.6%) were the most frequent causes of admission. No changes were observed in the proportion of alcoholic liver disease or drug-induced hepatitis in both study periods. The prevalence of viral hepatitis decreased in both genders, with hepatitis C decreasing from 32.4 to 9.7% for males and 35.4 to 10.8% for females, and OR=0.2; 95%CI 0.1–0.3 for both males and females. Similarly, the prevalence of hepatitis B decreased from 19.1 to 8.1% and OR=0.3; 95%CI 0.2–0.5 for males and 8.2 to 3.7% and OR=0.4; 95%CI 0.1–0.9 for females. The prevalence of autoimmune liver diseases increased only in males, from 2.1 to 5.9% and OR=2.9; 95%CI 1.2–6.6.

Over the past 4 years, there has been a shift in hospital admission profile at a Brazilian Hepatology Unit, with a decrease in viral hepatitis and an increase in autoimmune diseases and nonalcoholic fatty liver disease. Males were more affected at younger ages than females. Furthermore, ascites was the most prevalent cause of complications in both periods analyzed.