Global epidemiology of cirrhosis — aetiology, trends and predictions

Huang, Daniel Q.; Terrault, Norah A.; Tacke, Frank; Gluud, Lise Lotte; Arrese, Marco; Bugianesi, Elisabetta; Loomba, Rohit

doi:10.1038/s41575-023-00759-2

Cited by 260 publications

(119 citation statements)

References 128 publications

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“…This needs to be emphasized because the etiology of the underlying liver cirrhosis is different in Asia compared to the West. In North America, hepatitis C and in Europe, alcohol consumption is still the dominant etiology of cirrhosis whereas in Asia, chronic virus hepatitis B is most common [58]. Therefore, studies from Asia cannot necessarily be transferred to Western patients and especially European populations due to different underlying etiologies.…”

Section: Technical Adjustmentsmentioning

confidence: 99%

Hepatocellular Carcinoma: The Role of Surgery in Liver Cirrhosis

Koch,

Horné,

Fabritius

et al. 2024

Visc Med

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Background: Liver surgery is an essential component of hepatocellular carcinoma (HCC) treatment. Advances in surgical techniques and perioperative care have improved outcomes and have helped to expand surgical indications. However, liver fibrosis and cirrhosis still remain major problems for liver surgery due to the relevant impact on liver regeneration of the future liver remnant (FLR) after surgery. Especially in patients with clinically significant portal hypertension due to liver cirrhosis, surgery is limited. Despite recent efforts in developing predictive models, estimating the postoperative hepatic function remains difficult. Summary: In this review, we focus on the role of surgery in the treatment of HCC in structurally altered livers. The importance of assessing FLR with techniques such as contrast-enhanced CT, e.g., with the help of artificial intelligence is highlighted. Moreover, strategies for increasing the FLR with approaches like portal vein embolization and liver vein deprivation prior to surgery are discussed. Patient selection, minimally invasive liver surgery including robotic techniques, and perioperative concepts like the Enhanced Recovery After Surgery (ERAS) guidelines are identified as crucial parts of avoiding posthepatectomy liver failure. Key Message: The need for ongoing research to optimize patient selection criteria and perioperative care and to develop innovative biomarkers for outcome prediction is emphasized.

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Section: Technical Adjustmentsmentioning

confidence: 99%

Hepatocellular Carcinoma: The Role of Surgery in Liver Cirrhosis

Koch,

Horné,

Fabritius

et al. 2024

Visc Med

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“…Cirrhosis can lead to hepatocellular carcinoma (HCC) and hepatic decompensation (DC) and is an important cause of mortality worldwide. 5,6 In 2019, cirrhosis was associated with 2.4% of global deaths. 7 Overall mortality significantly differed between the etiologies of cirrhosis.…”

Section: Introductionmentioning

confidence: 99%

Changing spectrum and mortality disparities of etiology of liver cirrhosis in Beijing, China

Li,

Wei,

et al. 2024

Journal of Medical Virology

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Liver cirrhosis remains a major health concern globally, but its epidemiology and etiology evolve with time. However, the changing pattern in etiology and cause of liver‐related mortality for patients with cirrhosis are not fully elucidated. Herein, our aim was to characterize the temporal trend of the etiological spectrum and evaluate the impact of etiology on liver‐related death among patients with compensated cirrhosis (CC) in Beijing, China. Clinical profiles of patients with CC discharged between January 2008 and December 2015 were retrieved from the Beijing hospital discharge database. The mortalities of different etiologies of cirrhosis were calculated. The risks of readmission and liver‐related death associated with etiologies were evaluated by the Cox regression model. A total of 23 978 cirrhotic patients were included. The predominant cause was hepatitis B virus (HBV) (58.93%), followed by alcohol (21.35%), autoimmune (14.85%), miscellaneous etiologies (3.55%), and hepatitis C virus (HCV) (1.32%). From 2008 to 2015, the proportion of HBV‐related cirrhosis decreased to 28.11%. Meanwhile, the proportions of autoimmune‐ and miscellaneous‐related cirrhosis increased to 28.54% and 13.11%. The risk of liver‐related death ranked the highest in patients with miscellaneous cirrhosis, followed by HBV‐related cirrhosis, alcohol‐related cirrhosis, autoimmune‐related cirrhosis, and HCV‐related cirrhosis. The 5‐year rates of liver‐related death were 22.56%, 18.99%, 18.77%, 16.01%, and 10.76%, respectively. HBV‐related cirrhosis caused the highest risk of hepatocellular carcinoma (HCC)‐related death, whereas alcohol‐ and miscellaneous‐related cirrhosis caused higher risks of decompensation (DC)‐related death than HBV‐related cirrhosis, with hazard ratios of 1.35 (95% confidence interval [CI]: 1.24–1.48) and 1.20 (95% CI: 1.03–1.40), respectively. HBV remained a common cause of liver cirrhosis but gradually decreased. Mortality disparities existed in etiologies, with higher risks of HCC‐related death in HBV‐related cirrhosis, and DC‐related death in alcohol‐ and miscellaneous‐related cirrhosis.

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“…[2] The disease is an increasingly important contributor to global morbidity and mortality, emphasized by the substantial increase in fatty liver diseaserelated cirrhosis over the past decade. [3] The disease, which shares common metabolic risk factors with obesity, diabetes, and cardiovascular disease, [4,5] causes far-ranging health, social, and economic consequences that impact at the individual, community, and population levels. [6][7][8] Despite excess fat in the liver (hepatic steatosis) in the early stages of the disease, affected individuals generally experience few, nonspecific, symptoms (eg, fatigue, abdominal pain), commonly leading to a delayed diagnosis and worse health outcomes.…”

Section: Introductionmentioning

confidence: 99%

A global action agenda for turning the tide on fatty liver disease

et al. 2023

Self Cite

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Background & Aims: Fatty liver disease is a major public health threat due to its very high prevalence and related morbidity and mortality. Focused and dedicated interventions are urgently needed to target disease prevention, treatment, and care. Approach & Results: We developed an aligned, prioritized action agenda for the global fatty liver disease community of practice. Following a Delphi methodology over two rounds a large panel (R1 n = 344, R2 n = 288) reviewed the action priorities, via Qualtrics XM, indicating agreement using a four-point Likert-scale and providing written feedback. Priorities were revised between rounds and in R2 panelists also ranked the priorities within six domains: epidemiology, treatment and care, models of care, education and awareness, patient and community perspectives, and leadership and public health policy. The consensus fatty liver disease action agenda encompasses 29 priorities. In R2 the mean percentage of ‘agree’ responses was 82.4%, with all individual priorities having at least a super-majority of agreement (> 66.7% ‘agree’). The highest ranked action priorities included collaboration between liver specialists and primary care doctors on early diagnosis, action to address the needs of people living with multiple morbidities, and the incorporation of fatty liver disease into relevant non-communicable disease strategies and guidance. Conclusions: This consensus driven multidisciplinary fatty liver disease action agenda developed by care providers, clinical researchers, and public health and policy experts provides a path to reducing fatty liver disease prevalence and improve health outcomes. To implement this agenda, concerted efforts will be needed at the global, regional, and national levels.

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Global epidemiology of cirrhosis — aetiology, trends and predictions

Cited by 260 publications

References 128 publications

Hepatocellular Carcinoma: The Role of Surgery in Liver Cirrhosis

Hepatocellular Carcinoma: The Role of Surgery in Liver Cirrhosis

Changing spectrum and mortality disparities of etiology of liver cirrhosis in Beijing, China

A global action agenda for turning the tide on fatty liver disease

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