Table 1 Criteria used to assign the aetiology of the liver disease

1

Chronic hepatitis B infection

Evidence of CLD on liver ultrasound and positive serum HBsAg.

2

Chronic hepatitis C infection

Evidence of CLD on liver ultrasound and positive serum anti-HCV and positive HCV RNA.

3

Chronic hepatitis D infection

Chronic hepatitis B infection and positive serum anti HDV IgG confirmed by detection of HDV RNA.

4

Primary biliary cholangitis

i. Strongly positive anti-mitochondrial antibodies and

ii. Cholestatic liver function tests:

a. ALP > 1.5 x URR and

b. AST < 5 x URR

5

Autoimmune hepatitis^a

i. Strongly positive anti-nuclear antibodies or anti-actin and

ii. Elevated IgG > 1.1 x URR

6

Alcoholic liver disease

i. Clinical and radiological signs of CLD and

ii. Daily alcohol consumption > 20 g/day in women and > 30 g/day in men for 6 months or more.

7

Non-alcoholic fatty liver disease

i. Liver ultrasound findings of steatosis and

ii. Absence of significant alcohol consumption^b or other recognised secondary causes of steatosis and

iii. BMI > 25 kg/m^{2 c}

8

Haemochromatosis

i. Transferrin saturation > 50% and

ii. Genotyping showing C282Y homozygosity or C282Y/H63D heterozygosity or C282Y/S65C heterozygosity on the HFE gene.

9

Wilson’s disease

i. Serum caeruloplasmin < 0.140 g/L and

ii. Age < 40 years

10

Alpha-1-antitrypsin deficiency

Serum alpha-1-antitrypsin level < 0.85 g/L.

11

Malaria

Positive malaria rapid diagnostic test and positive microscopy.

12

Hepatic schistosomiasis

Presence of ova from Schistosoma mansoni in Kato-Katz thick stool smears and typical liver ultrasound findings viz. periportal thickening/‘pipestem’ fibrosis confirmed by an independent expert.

13

Visceral leishmaniasis

Ultrasound findings of hepatosplenomegaly and

positive K39 antigen strip test confirmed by positive splenic smear.

14

Unexplained chronic liver disease

None of the above