The global burden of liver disease: The major impact of China

Abstract

Liver disease is a major cause of illness and death worldwide. In China alone, liver diseases, primarily viral hepatitis (predominantly hepatitis B virus [HBV]), nonalcoholic fatty liver disease, and alcoholic liver disease, affect approximately 300 million people. The establishment of the Expanded Program on Immunization in 1992 has resulted in a substantial decline in the number of newly HBV‐infected patients; however, the number of patients with alcoholic and nonalcoholic fatty liver diseases is rising at an alarming rate. Liver cancer, one of the most deadly cancers, is the second‐most common cancer in China. Approximately 383,000 people die from liver cancer every year in China, which accounts for 51% of the deaths from liver cancer worldwide. Over the past 10 years, China has made some significant efforts to shed its “leader in liver diseases” title by investing large amounts of money in funding research, vaccines, and drug development for liver diseases and by recruiting many Western‐trained hepatologists and scientists. Over the last two decades, hepatologists and scientists in China have made significant improvements in liver disease prevention, diagnosis, management, and therapy. They have been very active in liver disease research, as shown by the dramatic increase in the number of publications in Hepatology. Nevertheless, many challenges remain that must be tackled collaboratively. In this review, we discuss the epidemiology and characteristics of liver diseases and liver‐related research in China. (Hepatology 2014;60:2098–2107)

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“…1 This cell death is triggered by autophagyinducing peptides, hypoxia-ischemia, and starvation and requires autophagy machinery. Autosis is genetically and biochemically distinct from apoptosis or necroptosis and is characterized by unique morphological features, including plasma membrane rupture.…”

“…Autosis is genetically and biochemically distinct from apoptosis or necroptosis and is characterized by unique morphological features, including plasma membrane rupture. 1 In 2008, we described a form of acute liver insufficiency associated with severe anorexia nersova (body mass index below 13 kg/m 2 ).…”

Liver disease in China: A long way to go

“…Table 2 in the article shows the increased number of inpatients with liver disease at one hospital in Beijing. 1 In our opinion, the data in this table may not have been representative of the national epidemiological trend of liver disease in China as a whole, in consideration of patient selection bias, the variation in different departments, and the adjustment of specialties in only one hospital. Obviously, data from a national or large regionally based census or national liver disease database would be more convincing here.…”

“…Frankly, we had similar concerns when we were preparing the special article. 1 Over the past two decades, Chinese hepatologists and scientists have made great progress in liver disease research with the support of a large amount of funding from the government, especially the National Grand Program on Key Infectious Disease. These funds have been used not only for optimization of hepatitis B virus (HBV) vaccination strategies for high-risk populations but also to explore better antiviral therapeutic approaches (e.g., combinations of various antiviral drugs) for the reduction of morbidity and mortality in patients with chronic HBV as well as other types of liver disease in China.…”

Research Progress of HOXA13/HOTTIP Gene and Digestive Tract Cancer

“…Liver cancer is the most heterogeneous and the highest mortality of refractory malignant tumor. The mortality rate of liver cancer in China is the second, second only to lung cancer [12] [13].…”