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Vol. 87. Issue 1.
Pages 127-128 (January - March 2022)
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Vol. 87. Issue 1.
Pages 127-128 (January - March 2022)
Letter to the Editor
Open Access
Determination of socioeconomic and cultural factors and regional etiologic variability in liver cirrhosis
Determinación de factores socioeconómicos y culturales y variabilidad etiológica regional de la cirrosis hepática
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M.B. Marca-Ventocilla
Corresponding author
marcos.marca@upsjb.edu.pe

Corresponding author at: Ex Hacienda Villa, Av. José Antonio Lavalle, s/n, Chorrillos, Lima, 15067, Peru. Tel.: (01) 254-5302.
, M.P. Huanca-Morales, L.A. Llanco-Albornoz
Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista-Sede Chorrillos, Lima, Peru
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Dear Editors,

We recently reviewed the original article, “Influence of socioeconomic and cultural factors in the etiology of cirrhosis of the liver” by Roesch et al.1. We believe the author should have included the income levels of the population analyzed, given that they are strongly associated with the self-care variable and etiologic variability in Mexico.

Park and Shin evaluated the monthly income of their patients with liver disease, categorizing them into 4 groups, according to income, observing better self-care behavior in patients with higher income (≥3,000 won) (33.3%) and poorer self-care behavior in lower-income patients (<1,000 won) (5%)2. Self-care is highly influenced by information sources, such as those provided by healthcare personnel (80.8%), newspapers and magazines (11.6%), and the experiences of other patients with cirrhosis of the liver (7.5%)2.

The analysis of the relation of economic factors to the etiology of liver cirrhosis in patients is a key element in all studies with an epidemiologic profile, as shown by Mukherjee et al. They conducted a study on a Hindu population that presented with severe forms of liver disease, including cirrhosis of the liver, and their association with poverty levels3. Hepatitis C virus (HCV) was the second most frequent etiologic agent in patients with the poorest economic status3.

Data on the etiology of liver cirrhosis can show considerable local variability, as was observed in different regions of India. The most frequent viral cause (HCV) was found in the Northern regions, hepatitis B virus (HBV) in the Eastern and Southern regions, and the non-viral etiology (alcohol) was found in the Northeastern region3. Likewise, in the Colombian epidemiologic characterization of liver cirrhosis carried out by Escorcia Charris and Marrugo Balceiro, they reported the distribution in 7 departments, finding a majority of patients diagnosed with cirrhosis of the liver in the Atlántico department (70.4%), whereas the other departments accounted for only 29.6%4. Unfortunately, their study did not include an analysis of the etiologies that predominated in each department −information that would be very useful for national health strategies.

We believe that the factors in the present study should have been studied further, given that they greatly influence the etiology of cirrhosis of the liver and the increase in the number of cases; cultural and environmental factors modify its etiology, as well.

Ethical considerations

Informed consent was not required for the drafting of the present document, given that it was written based on studies that included informed consent before participating in the research.

We declare that our article does not require authorization by the Research Ethics Committee of the Universidad Privada San Juan Bautista, because according to the Declaration of Helsinki and Resolution 008430 of October 4, 1993, the study under discussion was considered no risk research.

The authors declare that the present document contains no personal information that could identify patients.

Financial disclosure

No specific grants were received from public sector agencies, the business sector, or non-profit organizations in relation to this article.

Conflict of interest

The authors declare they have no economic interest or known personal relationships that could have influenced the content of the present document.

References
[1]
F. Roesch-Dietlen, M. González-Santes, Y.J. Sánchez-Maza, et al.
Influencia de los factores socioeconómicos y culturales en la etiología de la cirrosis hepática.
Rev Gastroenterol Mex, 86 (2021), pp. 28-35
[2]
H. Park, Y. Shin.
Factors related self-care behavior among liver cirrhosis patients: focusing on disease knowledge and family support.
J Korea Acad Industr Coop Soc, 18 (2017), pp. 647-656
[3]
P.S. Mukherjee, S. Vishnubhatla, D.N. Amarapurkar, et al.
Etiology and mode of presentation of chronic liver diseases in India: a multi centric study.
[4]
E.J. Escorcia-Charris, W.R. Marrugo-Balceiro.
Caracterización epidemiológica y clínica de la cirrosis hepática en un centro regional del Caribe Colombiano: clínica general del norte. Enero 2012 a marzo 2017.
Biociencias, 13 (2018), pp. 17-30

Please cite this article as: Marca-Ventocilla MB, Huanca-Morales MP, Llanco-Albornoz LA. Determinación de factores socioeconómicos y culturales y variabilidad etiológica regional de la cirrosis hepática. Rev Gastroenterol Méx. 2022;87:127–128.

Copyright © 2021. Asociación Mexicana de Gastroenterología
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