Cross-sectional study of the prevalence of chronic liver disease risk factors and liver fibrosis in a remotely living Indigenous Australian population

Objectives Remotely living Indigenous Australians have a disproportionate mortality from cirrhosis and hepatocellular cancer (HCC). However, there are no local population studies examining the prevalence of chronic liver disease (CLD) in remote communities. The main aims of this study were therefore to study a remote Indigenous population to determine the prevalence of CLD risk factors and the prevalence of significant fibrosis as defined by an Fibrosis-4 (FIB-4) score of ≥2.67. Methods The study design was a retrospective analysis of an electronic medical record database of a remote Aboriginal community-controlled health service. The setting was an Aboriginal community-controlled health service located in a remote South Australian town with a 15% Indigenous Australian population. Participants were all adult Indigenous Australians between the ages of 35 and 65 years. Results 83.9% of the study population had at least one CLD risk factor and 45% of the population had multiple CLD risk factors. The most prevalent risk factors were alcohol misuse, diabetes and obesity. 3.7% of the population had a high risk of significant fibrosis with an FIB-4 score≥2.67. Each additional CLD risk factor was associated with a 12.3% increase in FIB-4 mean (p=0.001). Conclusions CLD risk factors and significant liver fibrosis were highly prevalent in this population. Integrating simple liver screening tests into adult health checks has the potential to detect CLD at an early and treatable stage and to reduce the high morbidity and mortality from cirrhosis and HCC experienced by remotely living Indigenous Australians.