Liver Fibrosis in a Healthy Population in Jos, North-central Nigeria

Introduction: The excessive accumulation of extracellular matrix protein, primarily collagen, leads to the fibrosis of the liver, and when fibrosis becomes advanced, it leads to liver cirrhosis. Liver cirrhosis is progressive hepatic fibrosis characterized by distortion of the liver parenchyma and the formation of regenerative nodules. Globally, 59% of mortality and 46% of the global burden of diseases result from chronic liver diseases. Nigeria is one of the countries described as hyper-endemic for hepatitis B with attendant high mortality from the impact of chronic liver disease. Thus, early detection and determination of the disease burden are essential tools that will help in public interventions and the prioritization of intervention programs.

Aim: The study aims to determine the burden of liver fibrosis using FibroScan, in a healthy population.

Method: This cross-sectional observational study was carried among two hundred and twenty three (223) healthy individuals. Demographic data, weight, and height were determined and each of the patients had a FibroScan carried out to determine the degree of liver fibrosis. Blood was taken for hepatitis B and C tests.

Results: There were 223 participants; males were 106(47.53%) while females were 117(52.4%). The mean BMI was 26.53±5.47 kg/m2, it was 24.16±3.26 kg/m2 vs 28.98±6.22kg/m2 for males and females respectively, p=0007.

The median (IQR) fibrosis score for the general population was 5.4(4.4-6.7)kpa while it was 5.6(4.6-6.8) kpa vs. 5.2(4.2-6.7)kpa for males and females respectively p=0.10. Thirty seven (16.59%) participants had significant fibrosis (FibroScan score ≥7.2kpa), and 6 (2.7%) had liver cirrhosis (FibroScan > 12.5kpa). Fibrosis of the liver was associated with being obese, odds ratio1.20, [95% CI(0.43-3.3)], Alcohol ingestion, odds ratio 1.17,[95%CI(0.03-4.48)], and sex, odds ratio 2.03 [95% CI(0.82-5.01)].

Conclusion: Hepatic fibrosis is a significant cause of morbidity and mortality. Screening individuals at risk of liver fibrosis should be intensified in order to ensure early detection and deter further progression and complications.