Epidemiology

Cirrhosis is an important cause of morbidity and mortality. Cirrhosis and other chronic liver diseases are ranked as the 14th most common cause of death globally.[4] In 2019, about 2.4% of global deaths were due to cirrhosis.[5] An estimated 1.5 billion people globally have chronic liver diseases, with an age-standardized incidence of chronic liver diseases and cirrhosis of 25.35 per 100,000 people in 2019.[4][6] In 2017, the global prevalence of compensated cirrhosis was estimated to be 112 million cases and global prevalence of decompensated disease was estimated to be 10.6 million cases.[7]

In the US, cirrhosis affects around 2.2 million adults and is associated with mortality rates of 21.9 per 100,000 people.[3] Hospital admissions related to liver cirrhosis have increased in the US, from 3056 per 100,000 hospital admissions in 2012 to 3757 per 100,000 hospital admissions in 2016.[8]

In the UK, cirrhosis is a significant cause of premature mortality and years of working life lost.[9]

The majority of cases of chronic liver disease are accounted for by viral hepatitis, alcohol-related liver disease, and metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as nonalcoholic fatty liver disease (NAFLD).[7] Incidence of cirrhosis due to viral hepatitis has reduced following implementation of successful vaccination programs.[6][10]​ The prevalence of MASLD has increased in parallel with the obesity epidemic.[10] If this trend continues, it is expected that MASLD will become the most common cause of advanced liver disease and liver failure in the 21st century.[11][12]

In Europe, cirrhosis related to either viral infection (21% [13% hepatitis C virus infection; 7% hepatitis B virus infection]) or alcohol misuse (19%) are the main indications for liver transplant. Dual etiology liver cirrhosis caused by viral hepatitis and alcohol-related liver disease represents 3% of cases.[13]

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