Liver diseases in the Asia-Pacific region: a Lancet Gastroenterology & Hepatology Commission
- PMID: 31852635
- PMCID: PMC7164809
- DOI: 10.1016/S2468-1253(19)30342-5
Liver diseases in the Asia-Pacific region: a Lancet Gastroenterology & Hepatology Commission
Erratum in
-
Correction to Lancet Gastroenterol Hepatol 2020; 5: 167-228.Lancet Gastroenterol Hepatol. 2020 Mar;5(3):e2. doi: 10.1016/S2468-1253(20)30021-2. Lancet Gastroenterol Hepatol. 2020. PMID: 32061331 Free PMC article. No abstract available.
Abstract
The Asia-Pacific region is home to more than half of the global population and accounted for 62·6% of global deaths due to liver diseases in 2015. 54·3% of global deaths due to cirrhosis, 72·7% of global deaths due to hepatocellular carcinoma, and more than two-thirds of the global burden of acute viral hepatitis occurred in this region in 2015. Chronic hepatitis B virus (HBV) infection caused more than half of the deaths due to cirrhosis in the region, followed by alcohol consumption (20·8%), non-alcoholic fatty liver disease (NAFLD; 12·1%), and chronic infection with hepatitis C virus (HCV; 15·7%). In 2015, HBV accounted for about half the cases of hepatocellular carcinoma in the region. Preventive strategies for viral hepatitis-related liver disease include increasing access to clean drinking water and sanitation. HBV vaccination programmes for neonates have been implemented by all countries, although birth-dose coverage is extremely suboptimal in some. Availability of screening tests for blood and tissue, donor recall policies, and harm reduction strategies are in their initial stages in most countries. Many governments have put HBV and HCV drugs on their essential medicines lists and the availability of generic versions of these drugs has reduced costs. Efforts to eliminate viral hepatitis as a public health threat, together with the rapid increase in per-capita alcohol consumption in countries and the epidemic of obesity, are expected to change the spectrum of liver diseases in the Asia-Pacific region in the near future. The increasing burden of alcohol-related liver diseases can be contained through government policies to limit consumption and promote less harmful patterns of alcohol use, which are in place in some countries but need to be enforced more strictly. Steps are needed to control obesity and NAFLD, including policies to promote healthy lifestyles and regulate the food industry. Inadequate infrastructure and insufficient health-care personnel trained in liver diseases are issues that also need to be addressed in the Asia-Pacific region. The policy response of most governments to liver diseases has thus far been inadequate and poorly funded. There must be a renewed focus on prevention, early detection, timely referral, and research into the best means to introduce and improve health interventions to reduce the burden of liver diseases in the Asia-Pacific region.
Copyright © 2020 Elsevier Ltd. All rights reserved.
Figures
![Figure 1](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/7164809/bin/gr1_lrg.gif)
![Figure 2](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/7164809/bin/gr2_lrg.gif)
![Figure 3](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/7164809/bin/gr3_lrg.gif)
![Figure 4](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/7164809/bin/gr4_lrg.gif)
![Figure 5](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/7164809/bin/gr5_lrg.gif)
![Figure 6](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/7164809/bin/gr6_lrg.gif)
![Figure 7](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/7164809/bin/gr7_lrg.gif)
![Figure 8](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/7164809/bin/gr8_lrg.gif)
![Figure 9](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/7164809/bin/gr9_lrg.gif)
Comment in
-
Restricting alcohol consumption to reduce liver disease in the Asia-Pacific region.Lancet Gastroenterol Hepatol. 2020 Feb;5(2):105-107. doi: 10.1016/S2468-1253(19)30322-X. Epub 2019 Dec 15. Lancet Gastroenterol Hepatol. 2020. PMID: 31852636 No abstract available.
Similar articles
-
The changing epidemiology of liver diseases in the Asia-Pacific region.Nat Rev Gastroenterol Hepatol. 2019 Jan;16(1):57-73. doi: 10.1038/s41575-018-0055-0. Nat Rev Gastroenterol Hepatol. 2019. PMID: 30158570 Review.
-
Cost-effective options for the prevention and management of gastrointestinal and liver disease in the Asia-Pacific region.J Gastroenterol Hepatol. 2018 Jan;33(1):121-127. doi: 10.1111/jgh.13925. J Gastroenterol Hepatol. 2018. PMID: 28833619 Review.
-
Global mortality of chronic liver diseases attributable to Hepatitis B virus and Hepatitis C virus infections from 1990 to 2019 and projections to 2030.J Infect Public Health. 2024 Jul;17(7):102443. doi: 10.1016/j.jiph.2024.04.027. Epub 2024 May 8. J Infect Public Health. 2024. PMID: 38838606
-
Non-alcoholic steatohepatitis in the Asia-Pacific region: future shock?J Gastroenterol Hepatol. 2004 Apr;19(4):368-74. doi: 10.1111/j.1440-1746.2003.03252.x. J Gastroenterol Hepatol. 2004. PMID: 15012772 Review.
-
Treatment of chronic hepatitis C in Asia: when East meets West.J Gastroenterol Hepatol. 2009 Mar;24(3):336-45. doi: 10.1111/j.1440-1746.2009.05789.x. J Gastroenterol Hepatol. 2009. PMID: 19335784 Review.
Cited by
-
Key factor screening in mouse NASH model using single-cell sequencing combined with machine learning.Heliyon. 2024 Jun 25;10(13):e33597. doi: 10.1016/j.heliyon.2024.e33597. eCollection 2024 Jul 15. Heliyon. 2024. PMID: 39040415 Free PMC article.
-
Emodin alleviates cholestatic liver injury by modulating Sirt1/Fxr signaling pathways.Sci Rep. 2024 Jul 20;14(1):16756. doi: 10.1038/s41598-024-67882-1. Sci Rep. 2024. PMID: 39033253 Free PMC article.
-
Comparison of fatty liver index with fibroscan in non-alcoholic fatty liver disease.J Family Med Prim Care. 2024 Apr;13(4):1488-1495. doi: 10.4103/jfmpc.jfmpc_1789_23. Epub 2024 Apr 22. J Family Med Prim Care. 2024. PMID: 38827715 Free PMC article.
-
Metabolic dysfunction-associated fatty liver disease and low muscle strength: A comment.World J Gastroenterol. 2024 May 7;30(17):2371-2373. doi: 10.3748/wjg.v30.i17.2371. World J Gastroenterol. 2024. PMID: 38813051 Free PMC article.
-
MAFLD: an ideal framework for understanding disease phenotype in individuals of normal weight.Ther Adv Endocrinol Metab. 2024 May 27;15:20420188241252543. doi: 10.1177/20420188241252543. eCollection 2024. Ther Adv Endocrinol Metab. 2024. PMID: 38808010 Free PMC article. Review.
References
-
- WHO Global Health Estimates 2015: deaths by cause, age, sex, by country and by region, 2000–2015. 2016. https://www.who.int/healthinfo/global_burden_disease/estimates_regional_...
-
- World Bank Country profiles. 2017. https://datacatalog.worldbank.org/dataset/country-profiles
-
- Ministry of Health Singapore Communicable diseases surveillance in Singapore 2016. 2017. https://www.moh.gov.sg/docs/librariesprovider5/resources-statistics/repo...
-
- Cooke GS, Andrieux-Meyer I, Applegate TL. Accelerating the elimination of viral hepatitis: a Lancet Gastroenterology & Hepatology Commission. Lancet Gastroenterol Hepatol. 2019;4:135–184. - PubMed
-
- Shan S, Cui F, Jia J. How to control highly endemic hepatitis B in Asia. Liver Int. 2018;38(suppl 1):122–125. - PubMed
Uncited Reference
-
- New Zealand Government Sale and Supply of Alcohol Act 2012. 2012. http://www.legislation.govt.nz/act/public/2012/0120/latest/DLM3339333.html
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical