Author information

• ¹Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, United States; Center for Liver Disease, Department of Medicine, Inova Fairfax Medical Campus, Falls Church, VA, United States; Inova Medicine, Inova Health System, Falls Church, VA, United States. Electronic address: Zobair.Younossi@inova.org.
• ²Professor, Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong.
• ³Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom.
• ⁴Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, United States; Inova Medicine, Inova Health System, Falls Church, VA, United States; Center for Outcomes Research in Liver Disease, Washington DC, USA.

Abstract

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 (WHO) and/or the Global Burden of Disease (GBD) show that the burden of CLD is large and growing primarily due to the increasing burden of nonalcoholic fatty liver disease (NAFLD) and alcohol related liver disease (ALD). Middle East, Northern Africa and Asia regions of the globe are most affected by Hepatitis B (HBV) and Hepatitis C (HCV) viruses. Furthermore, the Middle East and North Africa regions are also affected by NAFLD and Eastern Europe, West Africa and the Central Asia 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 regions based on the sociodemographic index (SDI). On the other hand, the highest SDI countries are experiencing increasing rates of HCC. Assessing HCC burden based on country and etiology shows that China, Korea, India, Japan and Thailand have the highest HBV-related HCC cases while China, Japan, and the United States of America (USA) have highest HCV-related HCC cases. On the other hand, the USA has the highest ALD-related HCC cases while India, USA and Thailand have the highest non-alcoholic steatohepatitis (NASH)-related HCC cases. Although the burden of CLD is increasing globally, regions of the world are impacted differently due to a number of sociodemographic-factors.