Global Burden of Major Chronic Liver Diseases in 2021

Feng G 1 , Yilmaz Y 2 , Valenti L 3 , Seto WK 4 , Pan CQ 5 , Méndez-Sánchez N 6 Show all authors , Ye F 7 , Sookoian S 8 , Targher G 9 , Byrne CD 10 , Chan WK 11 , Treeprasertsuk S 12 , Yu HH 13 , Kim SU 14 , George J 15 , Xu WJ 1 , Sebastiani G 16 , Ocama P 17 , Ryan JD 18 , Lupșor-Platon M 19 , Ghazinyan H 20 , Hamid S 21 , Perera N 22 , Alswat K 23 , Isakov V 24 , Pan Q 25 , Sarin SK 26 , Schattenberg JM 27 , Sotoudeheian M 28 , Wong YJ 29 , Sharara AI 30 , Al-Busafi SA 31 , Opio CK 32 , Chai J 33 , Fouad Y 34 , Shi Y 35 , Al-Mahtab M 36 , Zhang S 37 , Pirola CJ 8 , Wong VW 38 , Zheng MH 39

Affiliations 

  • 1 Xi'an Medical University, Xi'an, China
  • 2 Department of Gastroenterology, School of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
  • 3 Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
  • 4 Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China
  • 5 Division of Gastroenterology and Hepatology, Department of Medicine, NYU Langone Health, New York University Grossman School of Medicine, New York, USA
  • 6 Liver Research Unit, Medica Sur Clinic & Foundation, Mexico City, Mexico
  • 7 The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
  • 8 Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
  • 9 Department of Medicine, University of Verona, Verona, Italy
  • 10 Southampton National Institute for Health and Care Research Biomedical Research Centre, University Hospital Southampton, and University of Southampton, Southampton General Hospital, Southampton, UK
  • 11 Gastroenterology and Hepatology Unit, Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  • 12 Medicine, Chulalongkorn University, Bangkok, Thailand
  • 13 Department of Gastroenterology and Hepatology, Kiang Wu Hospital, Macau, China
  • 14 Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, South Korea
  • 15 Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, Sydney, New South Wales, Australia
  • 16 Division of Gastroenterology and Hepatology, Chronic Viral Illness Service, McGill University Health Centre, Royal Victoria Hospital, Montreal, Canada
  • 17 Department of Medicine, Makerere University of College of Health Sciences, Kampala, Uganda
  • 18 Department of Hepatology, RCSI School of Medicine and Medical Sciences, Dublin/Beaumont Hospital, Dublin, Ireland
  • 19 Department of Medical Imaging, Regional Institute of Gastroenterology and Hepathology, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
  • 20 Gastroenterology and Hepatology Service, Yerevan Scientific Medical Center, Yerevan, Armenia
  • 21 Department of Medicine, Aga Khan University, Karachi, Pakistan
  • 22 Department of Medicine, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
  • 23 Liver Disease Research Center, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
  • 24 Department of Gastroenterology and Hepatology, Federal Research Center for Nutrition, Biotechnology and Food Safety, Moscow, Russia
  • 25 Department of Gastroenterology and Hepatology, Erasmus MC-University Medical Center, Rotterdam, the Netherlands
  • 26 Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
  • 27 Department of Internal Medicine II, Saarland University Medical Center, Homburg, Germany
  • 28 Physiology Research Center, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
  • 29 Department of Gastroenterology & Hepatology, Changi General Hospital, Singapore, Singapore
  • 30 Division of Gastroenterology and Hepatology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
  • 31 Department of Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
  • 32 Department of Medicine, Aga Khan University, Nairobi, Kenya
  • 33 Department of Gastroenterology, the First Affiliated Hospital (Southwest Hospital), Third Military Medical University (Army Medical University), Chongqing, China
  • 34 Department of Gastroenterology, Hepatology and Endemic Medicine, Minia University, Minia, Egypt
  • 35 State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
  • 36 Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
  • 37 Department of Gastroenterology, No 983 Hospital of Chinese People's Liberation Army, Tianjin, China
  • 38 Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
  • 39 MAFLD Research Center, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
Liver Int, 2025 Apr;45(4):e70058.
PMID: 40062742 DOI: 10.1111/liv.70058

Abstract

BACKGROUND: This study utilised the Global Burden of Disease data (2010-2021) to analyse the rates and trends in point prevalence, annual incidence and years lived with disability (YLDs) for major chronic liver diseases, such as hepatitis B, hepatitis C, metabolic dysfunction-associated liver disease, cirrhosis and other chronic liver diseases.

METHODS: Age-standardised rates per 100,000 population for prevalence, annual incidence and YLDs were compared across regions and countries, as well as the socio-demographic index (SDI). Trends were expressed as percentage changes (PC) and estimates were reported with uncertainty intervals (UI).

RESULTS: Globally, in 2021, the age-standardised rates per 100,000 population for the prevalence of hepatitis B, hepatitis C, MASLD and cirrhosis and other chronic liver diseases were 3583.6 (95%UI 3293.6-3887.7), 1717.8 (1385.5-2075.3), 15018.1 (13756.5-16361.4) and 20302.6 (18845.2-21791.9) respectively. From 2010 to 2021, the PC in age-standardised prevalence rates were-20.4% for hepatitis B, -5.1% for hepatitis C, +11.2% for MASLD and + 2.6% for cirrhosis and other chronic liver diseases. Over the same period, the PC in age-standardized incidence rates were -24.7%, -6.8%, +3.2%, and +3.0%, respectively. Generally, negative associations, but with fluctuations, were found between age-standardised prevalence rates for hepatitis B, hepatitis C, cirrhosis and other chronic liver diseases and the SDI at a global level. However, MASLD prevalence peaked at moderate SDI levels.

CONCLUSIONS: The global burden of chronic liver diseases remains substantial. Hepatitis B and C have decreased in prevalence and incidence in the last decade, while MASLD, cirrhosis and other chronic liver diseases have increased, necessitating targeted public health strategies and resource allocation.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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