Differences in presentations of hepatitis B and hepatitis C causing decompensated liver cirrhosis

Background: In Pakistan, prevalence of HBV is 2.6% and HCV is 5.3% with an overall decrease in incidence of HBV infection and an increase in HCV infection, however, the differences in their presentation and prognosis are not known. Methods: We conducted a prospective study on 325 patients who were admitted with a primary diagnosis of decompensated liver failure due to HBV or HCV at two major tertiary care hospitals . Statistical analysis was performed using SPSS version 20 and all values were considered significant at p<0.05.Results: Patients with HCV had esophageal varices (34.07 %) confirmed by endoscopy whereas, none of the patients with HBV had esophageal varices p<0.002. HBV patients most frequently had grade 0 hepatic encephalopathy (HE) (46.67%) whereas, HCV patients had grade 3 HE (38.30%); p<0.005. Peripheral edema was found to be significant amongst patients with HBV and HCV; p<0.023. Conclusion: HCV causes a higher incidence of decompensated liver cirrhosis than HBV leading to liver failure. Major manifestations are neurological with a smaller portion being related to gastrointestinal tract and edema of extremities. Being able to detect these changes promptly can halt the progress of disease. Having a primary prevention program in place will help with the future burden of disease.