Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
J Med Virol. 2023 Jun;95(6):e28858. doi: 10.1002/jmv.28858.
Cirrhosis remains a major public health concern globally; the burden of cirrhosis should be further clarified worldwide and helped us to understand the current situation of cirrhosis. In the present study, we estimate DALYs and mortality rates attributable to several major cirrhosis risk factors and use joinpoint and age-period-cohort methods to determine the trends of cirrhosis incidence and deaths in the global population in the 1990-2019 period. Globally, from 1990 to 2019, the incidence of cirrhosis, deaths due to cirrhosis, and cirrhosis DALY cases increased from 1274 (10 , 95% uncertainty interval [UI]: 1027.2-1548.5) to 2051.6 (10 , 95% UI: 1661.4-2478.1), 1013 (10 , 95% UI: 948.9-1073.9) to 1472 (10 , 95% UI: 1374.6-1578.7), and 34727.7 (10 , 95% UI: 32383.0-37132.8) to 46189.4 (10 , 95% UI: 43027.1-49551.3), respectively. Hepatitis virus was the most important cirrhosis mortality risk factor. Globally, hepatitis virus infection (HBV+HCV) accounted for more than 45% of the incidence of cirrhosis cases and about 50% of cirrhosis deaths. Importantly, from 1990 to 2019, the proportion of cirrhosis incidence due to HBV decreased from 24.3% to 19.8%, whereas that due to alcohol use increased from 18.7% to 21.3%. Additionally, the proportion of NAFLD-induced cirrhosis incidence increased from 5.5% to 6.6% over the same period. Our findings on the global disease burden of cirrhosis provide a valuable resource for developing targeted prevention strategies.
肝硬化仍然是全球主要的公共卫生关注点；需要在全球范围内进一步明确肝硬化的负担，以帮助我们了解当前肝硬化的情况。在本研究中，我们估计了几个主要肝硬化风险因素导致的残疾调整生命年（DALY）和死亡率，并使用 joinpoint 和年龄-时期-队列方法来确定全球人群在 1990-2019 年期间肝硬化发病率和死亡率的趋势。
全球范围内，1990 年至 2019 年，肝硬化发病率、肝硬化死亡人数和肝硬化 DALY 病例数分别从 1274（10 ，95%不确定区间 [UI]：1027.2-1548.5）上升至 2051.6（10 ，95% UI：1661.4-2478.1）、1013（10 ，95% UI：948.9-1073.9）上升至 1472（10 ，95% UI：1374.6-1578.7）和 34727.7（10 ，95% UI：32383.0-37132.8）上升至 46189.4（10 ，95% UI：43027.1-49551.3）。肝炎病毒是最重要的肝硬化死亡风险因素。全球范围内，肝炎病毒感染（HBV+HCV）导致的肝硬化病例占比超过 45%，肝硬化死亡人数占比约 50%。重要的是，1990 年至 2019 年，HBV 导致的肝硬化发病率比例从 24.3%下降至 19.8%，而酒精使用导致的肝硬化发病率比例从 18.7%上升至 21.3%。此外，NAFLD 导致的肝硬化发病率比例同期从 5.5%上升至 6.6%。我们对全球肝硬化疾病负担的研究结果为制定有针对性的预防策略提供了有价值的资源。
