What are the main causes of cirrhosis nowadays?
Pere Ginès: The antiviral treatment for hepatitis C is going to change the epidemiology of cirrhosis all over the world, particularly in the countries where hepatitis C was very common. In Spain, as well as in other countries in Europe, we are seeing a reduction in the number of patients admitted to the hospital because of complications of hepatitis C–induced cirrhosis.
There are 2 main etiological factors now in patients admitted to the hospital. The first one is alcohol; alcohol is probably also increasing in our country. The second, which is growing rapidly, is NAFLD-associated cirrhosis, or nonalcoholic fatty liver disease–associated cirrhosis. This is going to be a huge problem in the future, so we have to start facing it together with other physicians working in other specialties, particularly endocrinologists and also general practitioners.