Which patient group is usually not severely malnourished?

• A. Alcoholic liver disease
• B. Cirrhosis due to alcohol
• C. Decompensated cirrhosis
• D. Compensated viral diseases

Answer: (D)

Malnutrition in liver disease rises with the degree of liver dysfunction and systemic catabolic stress. When cirrhosis is decompensated, or when alcohol-related liver disease is present, ongoing poor intake, malabsorption, fluid shifts from ascites, hepatic encephalopathy, and a hypermetabolic state drive loss of lean body mass and overall malnutrition. In contrast, compensated viral diseases imply liver injury without major complications like ascites or encephalopathy, so nutritional status tends to be preserved and severe malnutrition is less common.