Research Paper Volume 13, Issue 1 pp 279—300

The burden of liver cirrhosis and underlying etiologies: results from the global burden of disease study 2017

Mimi Zhai1, *, , Jianhai Long2, *, , Sushun Liu3, , Chun Liu3, , Li Li3, , Leping Yang3, , Yamin Li1,4, , Bo Shu3, ,

  • 1 Xiangya Nursing School, Central South University, Changsha, Hunan 410013, China
  • 2 Department of Respiratory, Beijing Tiantan Hospital, Capital Medicine University, Beijing 100050, China
  • 3 Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
  • 4 Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
* Equal contribution

Received: April 29, 2020       Accepted: September 19, 2020       Published: January 12, 2021
How to Cite

Copyright: © 2021 Zhai et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Background: To evaluate the pattern and prevalence trends of liver cirrhosis caused by specific etiologies.

Results: Globally, the number of prevalent cases increased 74.53% from 1990 to 2017. The ASR increased 0.75 per year. The most pronounced increases were found in middle-high and high socio-demographic index (SDI) regions, especially in the Caribbean and Latin America. Among the etiologies, non-alcoholic steatohepatitis (NASH) related liver cirrhosis accounted for 59.46% of the cases. The ASR increased 1.74 per year, and the increase was observed in all 5 SDI regions. In addition, the ASR of liver cirrhosis caused by alcohol also increased in both sexes and all SDI regions. In contrast, the ASR of liver cirrhosis caused by hepatitis B virus (HBV) and hepatitis C virus (HCV) decreased, especially in middle and low-middle SDI regions.

Conclusions: Though the number of people suffering from HBV and HCV decreases, liver cirrhosis is still a major threat to health. Additionally, the number of people with cirrhosis caused by alcohol and NASH continues to grow. Thus, more targeted and specific strategies should be established based on etiology and prevalence trends of liver cirrhosis.

Methods: We collected data based on Global Burden of Disease (GBD) 2017 study. The age standardized prevalence rate (ASR) and estimated annual percentage changes (EAPC) were used to estimate the trends in prevalence by population, etiologies and regions.


ASR: Age standardized prevalence rate; CI: confidence interval; EAPC: estimated annual percentage changes; GBD: Global burden of disease; HBV: hepatitis B virus; HCV: hepatitis C virus; HDI: human development index; NASH: non-alcoholic steatohepatitis; SDI: socio-demographic index.