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. 2024 Feb 3;24(1):363.
doi: 10.1186/s12889-024-17948-6.

Global burden of liver cirrhosis and other chronic liver diseases caused by specific etiologies from 1990 to 2019

Xiao-Ning Wu  1   2 , Feng Xue  1 , Nan Zhang  1   2 , Wei Zhang  1   2 , Jing-Jing Hou  1   2 , Yi Lv  1   2 , Jun-Xi Xiang  3   4 , Xu-Feng Zhang  5   6
Affiliations

Global burden of liver cirrhosis and other chronic liver diseases caused by specific etiologies from 1990 to 2019

Xiao-Ning Wu et al. BMC Public Health. .

Abstract

Background: This study aimed to assess the global, regional, and national burden of liver cirrhosis and other chronic liver diseases between 1990 and 2019, considering five etiologies (hepatitis B, hepatitis C, alcohol use, NAFLD and other causes), age, gender, and sociodemographic index (SDI).

Methods: Data on liver cirrhosis and other chronic liver diseases mortality, incidence, and disability-adjusted life years (DALYs) were collected from the Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study 2019.

Results: In 2019, liver cirrhosis and other chronic liver diseases accounted for 1,472,011 (95% UI 1,374,608-1,578,731) deaths worldwide, compared to 1,012,975 (948,941-1,073,877) deaths in 1990. Despite an increase in absolute deaths, the age-standardized death rate declined from 24.43 (22.93-25.73) per 100,000 population in 1990 to 18.00 (19.31-16.80) per 100,000 population in 2019. Eastern sub-Saharan Africa exhibited the highest age-standardized death rate (44.15 [38.47-51.91] per 100,000 population), while Australasia had the lowest rate (5.48 [5.05-5.93] deaths per 100,000 population in 2019). The age-standardized incidence rate of liver cirrhosis and other chronic liver diseases attributed to hepatitis B virus has declined since 1990, but incidence rates for other etiologies have increased. Age-standardized death and DALYs rates progressively decreased with higher SDI across different GBD regions and countries. Mortality due to liver cirrhosis and other chronic liver diseases increased with age in 2019, and the death rate among males was estimated 1.51 times higher than that among females globally.

Conclusion: Liver cirrhosis and other chronic liver diseases continues to pose a significant global public health challenge. Effective disease control, prevention, and treatment strategies should account for variations in risk factors, age, gender, and regional disparities.

Keywords: Chronic liver disease; Global burden of disease 2019; Incidence; Liver cirrhosis; Mortality.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Number of mortality and ASMR at the global level by etiology of liver cirrhosis and other chronic liver diseases, 1990–2019. COHB, liver cirrhosis and other chronic liver diseases due to hepatitis B. COHC, liver cirrhosis and other chronic liver diseases due to hepatitis C. COAU, liver cirrhosis and other chronic liver diseases due to alcohol use. CONA, liver cirrhosis and other chronic liver diseases due to NAFLD. COOC, liver cirrhosis and other chronic liver diseases due to other cause. ASMR, age-standardized mortality rate
Fig. 2
Fig. 2
Age-standardized mortality rate for liver cirrhosis and other chronic liver diseases, by region and etiology, 2019. COHB, liver cirrhosis and other chronic liver diseases due to hepatitis B. COHC, liver cirrhosis and other chronic liver diseases due to hepatitis C. COAU, liver cirrhosis and other chronic liver diseases due to alcohol use. CONA, liver cirrhosis and other chronic liver diseases due to NAFLD. COOC, liver cirrhosis and other chronic liver diseases due to other cause
Fig. 3
Fig. 3
Contribution of COHB, COHC, COAU, CONA, and COOC to liver cirrhosis and other chronic liver diseases mortality, both sexes, globally and by region, 2019. COHB, liver cirrhosis and other chronic liver diseases due to hepatitis B. COHC, liver cirrhosis and other chronic liver diseases due to hepatitis C. COAU, liver cirrhosis and other chronic liver diseases due to alcohol use. CONA, liver cirrhosis and other chronic liver diseases due to NAFLD. COOC, liver cirrhosis and other chronic liver diseases due to other cause
Fig. 4
Fig. 4
The global age-standardized rate of liver cirrhosis and other chronic liver diseases per 100,000 populations in 2019, by country and territory. (A) ASMR in 2019; (B) ASIR in 2019; and (C) ASDR in 2019. ASMR, age-standardized mortality rate. ASIR, age-standardized incidence rate. ASDR, age-standardized DALYs rate
Fig. 5
Fig. 5
Global liver cirrhosis and other chronic liver diseases mortality by etiology and age for females and males, 2019. For each group, the left column showed case data in female and the right column shows data in male. COHB, liver cirrhosis and other chronic liver diseases due to hepatitis B. COHC, liver cirrhosis and other chronic liver diseases due to hepatitis C. COAU, liver cirrhosis and other chronic liver diseases due to alcohol use. CONA, liver cirrhosis and other chronic liver diseases due to NAFLD. COOC, liver cirrhosis and other chronic liver diseases due to other cause
Fig. 6
Fig. 6
ASMR of liver cirrhosis and other chronic liver diseases by SDI: (A) ASMR in global and 21 GBD regions, 1990–2019. (B) ASMR in 204 countries and territories, 2019. Expected values based on sociodemographic index and disease rates in all locations are shown as the black line. ASMR, age-standardized mortality rate; GBD, global burden of diseases, injuries, and risk factors study; SDI, sociodemographic index
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