Brad Walker, MD1, Peter Ceglowski, MD1, Shoheera Punjwani, DO1, Chinmay Jani, MD1, Elena Fradkov, MD2 1Mount Auburn Hospital, Cambridge, MA; 2Mount Auburn Hospital, Boston, MA
Introduction: Cirrhosis remains the leading cause of liver-related death globally. Cirrhosis is irreversible, making early detection and treatment of the underlying cause vital in preventing liver-related death. This study aims to compare age-standardized prevalence and mortality rates of the most common causes of cirrhosis in the US vs global rates to assess potential detection success and disease management.
Methods: This is an observational cross-sectional analysis of age-standardized prevalence rates (ASPR) and age-standardized mortality rates (ASMR) of modifiable etiologies of cirrhosis using the Global Burden of Disease database. Causes of cirrhosis included in this analysis are alcohol-related disease, hepatitis B, hepatitis C, non-alcoholic fatty liver disease (NAFLD), and other causes not specified, such as autoimmune. This study compares global and US ASPR and ASMR (reported per 100,000) from 1990 to 2019.
Results: Cirrhosis was most prevalent in the NAFLD population, with global males exhibiting the highest ASPR (16789) followed by global females (13278). ASPR of alcohol cirrhosis revealed lower rates in global and US females compared to their male counterparts, with US males showing a decline since 2000. ASPR of hepatitis B cirrhosis revealed symmetry between US genders and global genders, with the US exhibiting lower rates. ASPR of hepatitis C cirrhosis exhibited a similar trend to hepatitis B. NAFLD cirrhosis exhibited the largest ASPR among all etiologies, with consistent increase across all genders and locations over the 30-year period. ASMR of cirrhosis decreased for both genders and all causes between 1990 and 2019, globally and in the US, except for US males and females with cirrhosis due to hepatitis C and NAFLD.
Discussion: GBD data from 1990 to 2019 reveals multiple trends in cirrhosis ASPR and ASMR. NAFLD-related disease exhibited the most consistent increase in ASPR across all study groups and reported the greatest ASPR rates among all cirrhotic etiologies studied. This data is particularly concerning that there may be insufficient detection and treatment of NAFLD prior to cirrhosis progression. Fortunately, the ASMR rates of most cirrhotic etiologies reported a declining or relatively stagnant rate, suggesting improved cirrhotic management. However, several groups exhibited increasing ASMR, with US males exhibiting the greatest ASMR rates of cirrhosis due to hepatitis C, suggesting a necessity to improve detection and treatment.
Figure: Figure 1: Age-standardized prevalence rates (ASPR) of males and females in the US and globally from 1990 to 2019.
Disclosures:
Brad Walker indicated no relevant financial relationships.
Peter Ceglowski indicated no relevant financial relationships.
Shoheera Punjwani indicated no relevant financial relationships.
Chinmay Jani indicated no relevant financial relationships.
Elena Fradkov indicated no relevant financial relationships.
Brad Walker, MD1, Peter Ceglowski, MD1, Shoheera Punjwani, DO1, Chinmay Jani, MD1, Elena Fradkov, MD2, 41, Age-Standardized Comparison of Cirrhosis Trends Due to Multiple Etiologies in the US vs Global, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.
