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. 2025 Apr;45(4):e70058.
doi: 10.1111/liv.70058.

Global Burden of Major Chronic Liver Diseases in 2021

Gong Feng  1   2 , Yusuf Yilmaz  3 , Luca Valenti  4   5 , Wai-Kay Seto  6   7   8 , Calvin Q Pan  9 , Nahum Méndez-Sánchez  10 , Feng Ye  2 , Silvia Sookoian  11   12   13 , Giovanni Targher  14   15 , Christopher D Byrne  16 , Wah-Kheong Chan  17 , Sombat Treeprasertsuk  18 , Hon Ho Yu  19 , Seung Up Kim  20 , Jacob George  21 , Wen-Jing Xu  1 , Giada Sebastiani  22 , Ponsiano Ocama  23 , John D Ryan  24 , Monica Lupșor-Platon  25 , Hasmik Ghazinyan  26 , Saeed Hamid  27 , Nilanka Perera  28 , Khalid Alswat  29 , Vasily Isakov  30 , Qiuwei Pan  31 , Shiv Kumar Sarin  32 , Jörn M Schattenberg  33 , Mohammadjavad Sotoudeheian  34   35 , Yu Jun Wong  36   37 , Ala I Sharara  38 , Said A Al-Busafi  39 , Christopher Kenneth Opio  40 , Jin Chai  41   42   43 , Yasser Fouad  44 , Yu Shi  45 , Mamun Al-Mahtab  46 , Sujuan Zhang  47 , Carlos Jose Pirola  11   48 , Vincent Wai-Sun Wong  49 , Ming-Hua Zheng  50   51
Affiliations

Global Burden of Major Chronic Liver Diseases in 2021

Gong Feng et al. Liver Int. 2025 Apr.

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.

Keywords: chronic liver diseases; global burden of diseases; incidence; prevalence.

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