New multicentre research indicates that metabolic dysfunction-associated steatotic liver disease (MASLD) is potentially the leading cause of cirrhosis in parts of South America. The study examined patients across six countries.
Cirrhosis, characterized by liver scarring, can progress from a compensated state to decompensated disease with severe complications like fluid accumulation and liver cancer, drastically reducing survival. Globally, cirrhosis is a significant cause of death.
Historically, alcohol-related liver disease (ALD) and hepatitis C were considered primary culprits in Latin America. However, contemporary data was limited.
The South American Liver Research Network study analyzed 1,780 adults with confirmed cirrhosis in Argentina, Brazil, Colombia, Chile, Ecuador, and Peru. Over half presented with decompensated disease, with many experiencing their first complication at diagnosis.
Comorbid conditions were prevalent, including obesity (32%), diabetes (33.7%), and hypertension (36.2%). The median body mass index placed the cohort in the overweight range.
MASLD, alone or combined with alcohol (MetALD), accounted for 34.1% of cases. When all MASLD-related combinations were considered, the figure rose to 39.3%. Viral causes represented 19.8%, autoimmune liver diseases 18%, and ALD alone 16.3%.
During follow-up, 63.5% of patients developed liver-related complications, most commonly ascites. Around 28% underwent transplant evaluation.
Researchers suggest the shift from alcohol as the dominant cause may reflect increasing metabolic risk factors, potential underreporting of alcohol intake, or updated classifications. Despite limitations, the study provides a contemporary overview and highlights cirrhosis as a significant concern for both men and women.
The findings may inform public health strategies amid rising obesity, diabetes, and MASLD prevalence in the region.