The burden of liver cirrhosis and underlying etiologies: results from the global burden of disease study 2017

Mimi Zhai, Jianhai Long, Sushun Liu, Chun Liu, Li Li, Leping Yang, Yamin Li, Bo Shu, Mimi Zhai, Jianhai Long, Sushun Liu, Chun Liu, Li Li, Leping Yang, Yamin Li, Bo Shu

Abstract

Background: To evaluate the pattern and prevalence trends of liver cirrhosis caused by specific etiologies.

Results: Globally, the number of prevalent cases increased 74.53% from 1990 to 2017. The ASR increased 0.75 per year. The most pronounced increases were found in middle-high and high socio-demographic index (SDI) regions, especially in the Caribbean and Latin America. Among the etiologies, non-alcoholic steatohepatitis (NASH) related liver cirrhosis accounted for 59.46% of the cases. The ASR increased 1.74 per year, and the increase was observed in all 5 SDI regions. In addition, the ASR of liver cirrhosis caused by alcohol also increased in both sexes and all SDI regions. In contrast, the ASR of liver cirrhosis caused by hepatitis B virus (HBV) and hepatitis C virus (HCV) decreased, especially in middle and low-middle SDI regions.

Conclusions: Though the number of people suffering from HBV and HCV decreases, liver cirrhosis is still a major threat to health. Additionally, the number of people with cirrhosis caused by alcohol and NASH continues to grow. Thus, more targeted and specific strategies should be established based on etiology and prevalence trends of liver cirrhosis.

Methods: We collected data based on Global Burden of Disease (GBD) 2017 study. The age standardized prevalence rate (ASR) and estimated annual percentage changes (EAPC) were used to estimate the trends in prevalence by population, etiologies and regions.

Keywords: etiology; global burden of disease study; liver cirrhosis.

Conflict of interest statement

CONFLICTS OF INTEREST: The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
The worldwide prevalence cases of liver cirrhosis in 195 countries and territories. (A) The worldwide prevalence cases of liver cirrhosis in 1990. (B) The worldwide prevalence cases of liver cirrhosis in 2017.
Figure 2
Figure 2
The global burden of liver cirrhosis in 195 countries and territories. (A) The ASR of liver cirrhosis in 1990. (B) The ASR of liver cirrhosis in 2017. (C) The EAPC of liver cirrhosis from 1990 to 2017.
Figure 3
Figure 3
The analysis of liver cirrhosis and its etiologies. The liver cirrhosis cases caused by different etiologies, by SDI regions.
Figure 4
Figure 4
The analysis of liver cirrhosis at a regional level. (A) The prevalence cases of liver cirrhosis caused by different etiologies in different region and sex. (B) The prevalence cases of liver cirrhosis in different regions. (C) The ASR of liver cirrhosis in different regions.
Figure 5
Figure 5
(A) Composition ratio of each etiology in prevalence cases of liver cirrhosis in 1990 and 2017. (B) The correlation between EAPC and ASR in 1990, HDI in 2017.

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