The Global Burden of Liver Disease

Chronic liver disease (CLD) and its associated complications (cirrhosis and liver cancer) cause significant mortality, morbidity, and economic burden. Published data from the World Health Organization and/or the Global Burden of Disease show that the burden of CLD is large and increasing, primarily owing to the increasing burden of nonalcoholic fatty liver disease and alcohol-related liver disease (ALD). Middle Eastern, Northern African, and Asian regions of the globe are most affected by hepatitis B and hepatitis C virus. Furthermore, Middle Eastern and North African regions also are affected by nonalcoholic fatty liver disease, and Eastern European, West African, and Central Asian regions are affected by ALD. In this context, the rate of increase for cirrhosis is highest in the Middle East, as well as in middle high and high sociodemographic index (SDI) regions. On the other hand, the highest SDI countries are experiencing increasing rates of hepatocellular carcinoma (HCC). Assessing HCC burden based on country and etiology shows that China, Korea, India, Japan, and Thailand have the highest hepatitis B virus–related HCC cases, while China, Japan, and the United States have the highest hepatitis C virus–related HCC cases. Additionally, the United States has the highest ALD-related HCC cases, while India, the United States, and Thailand have the highest nonalcoholic steatohepatitis–related HCC cases. Although the burden of CLD is increasing globally, regions of the world are impacted differently as a result of a number of sociodemographic factors. Chronic liver disease (CLD) and its associated complications (cirrhosis and liver cancer) cause significant mortality, morbidity, and economic burden. Published data from the World Health Organization and/or the Global Burden of Disease show that the burden of CLD is large and increasing, primarily owing to the increasing burden of nonalcoholic fatty liver disease and alcohol-related liver disease (ALD). Middle Eastern, Northern African, and Asian regions of the globe are most affected by hepatitis B and hepatitis C virus. Furthermore, Middle Eastern and North African regions also are affected by nonalcoholic fatty liver disease, and Eastern European, West African, and Central Asian regions are affected by ALD. In this context, the rate of increase for cirrhosis is highest in the Middle East, as well as in middle high and high sociodemographic index (SDI) regions. On the other hand, the highest SDI countries are experiencing increasing rates of hepatocellular carcinoma (HCC). Assessing HCC burden based on country and etiology shows that China, Korea, India, Japan, and Thailand have the highest hepatitis B virus–related HCC cases, while China, Japan, and the United States have the highest hepatitis C virus–related HCC cases. Additionally, the United States has the highest ALD-related HCC cases, while India, the United States, and Thailand have the highest nonalcoholic steatohepatitis–related HCC cases. Although the burden of CLD is increasing globally, regions of the world are impacted differently as a result of a number of sociodemographic factors. Chronic liver disease (CLD) and associated cirrhosis accounts for approximately 1 million deaths per year. In addition to its clinical burden, CLD causes significant morbidity, impairment of health-related quality of life (HRQL), and economic burden.1Asrani S.K. Devarbhavi H. Eaton J. Kamath P.S. Burden of liver diseases in the world.J Hepatol. 2019; 70: 151-171Abstract Full Text Full Text PDF PubMed Scopus (1522) Google Scholar Although there are a number of causes of liver disease, the 4 major drivers of this CLD-related burden include chronic hepatitis C virus (CHC), chronic hepatitis B virus (CHB), alcohol-related liver disease (ALD), and nonalcoholic fatty liver disease (NAFLD). In fact, given the pandemic of obesity, its associated liver disease, NAFLD, is increasing and is predicted to continue to do so.2Paik J.M. Golabi P. Younossi Y. et al.Changes in the global burden of chronic liver diseases from 2012 to 2017: the growing impact of NAFLD.Hepatology. 2020; 72: 1605-1616Crossref PubMed Scopus (272) Google Scholar, 3Estes C. Anstee Q.M. Arias-Loste M.T. et al.Modeling NAFLD disease burden in China, France, Germany, Italy, Japan, Spain, United Kingdom, and United States for the period 2016-2030.J Hepatol. 2018; 69: 896-904Abstract Full Text Full Text PDF PubMed Scopus (876) Google Scholar, 4Estes C. Razavi H. Loomba R. et al.Modeling the epidemic of nonalcoholic fatty liver disease demonstrates an exponential increase in burden of disease.Hepatology. 2018; 67: 123-133Crossref PubMed Scopus (1108) Google Scholar, 5Estes C. Chan H.L.Y. Chien R.N. et al.Modelling NAFLD disease burden in four Asian regions-2019-2030.Aliment Pharmacol Ther. 2020; 51: 801-811Crossref PubMed Scopus (66) Google Scholar, 6World Health OrganizationEstimated mortality rate from cirrhosis and other chronic liver diseases.https://www.who.int/data/gho/indicator-metadata-registry/imr-details/1179Date accessed: December 13, 2022Google Scholar, 7World Health Statistics.file:///C:/Users/User/Downloads/9789240051140-eng.pdfDate accessed: December 13, 2022Google Scholar, 8Rehm J. Gmel Sr., G.E. Gmel G. et al.The relationship between different dimensions of alcohol use and the burden of disease-an update.Addiction. 2017; 112: 968-1001Crossref PubMed Scopus (593) Google Scholar, 9Rehm J. Imtiaz S. A narrative review of alcohol consumption as a risk factor for global burden of disease.Subst Abuse Treat Prev Policy. 2016; 11: 37Crossref PubMed Scopus (105) Google Scholar, 10Messina J.P. Humphreys I. Flaxman A. et al.Global distribution and prevalence of hepatitis C virus genotypes.Hepatology. 2015; 61: 77-87Crossref PubMed Scopus (1173) Google Scholar, 11Schwarzinger M. Baillot S. Y. et use and the burden of chronic hepatitis C in France, a Hepatol. 2017; 67: Full Text Full Text PDF PubMed Scopus Google Scholar, J. Global burden of alcohol use and alcohol liver 2019; PubMed Scopus Google Scholar, Golabi P. J.M. et al.The global of nonalcoholic fatty liver disease and a review and PubMed Scopus Google Scholar the of CLD is for and global to this review an of the burden and to 4 major causes of CLD from a global the World Health Organization that million have approximately million and approximately deaths Health OrganizationEstimated mortality rate from cirrhosis and other chronic liver diseases.https://www.who.int/data/gho/indicator-metadata-registry/imr-details/1179Date accessed: December 13, 2022Google Health Statistics.file:///C:/Users/User/Downloads/9789240051140-eng.pdfDate accessed: December 13, 2022Google Scholar Furthermore, is that million and are highest burden of is in the Eastern and by the and the Health OrganizationEstimated mortality rate from cirrhosis and other chronic liver diseases.https://www.who.int/data/gho/indicator-metadata-registry/imr-details/1179Date accessed: December 13, 2022Google Health Statistics.file:///C:/Users/User/Downloads/9789240051140-eng.pdfDate accessed: December 13, 2022Google Disease by Global Organization liver B million million most Eastern million most and million most C million million million most Eastern regions of the million million million per million from most and million million most Eastern and fatty liver by the as a million are to have NAFLD per most Middle and North by China, India, and highest rate per burden of mortality and life liver deaths for of liver highest life Eastern West Central of of and prevalence of deaths from liver of liver of is alcohol-related liver Global Burden of World Health from et M. 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