Contemporary Epidemiology of Chronic Liver Disease and Cirrhosis

Andrew M. Moon, Amit G. Singal, Elliot B. Tapper

Research output: Contribution to journalReview articlepeer-review

334 Scopus citations


Background & Aims: Accurate estimates for the contemporary burden of chronic liver disease (CLD) are vital for setting clinical, research, and policy priorities. We aimed to review the incidence, prevalence, and mortality of CLD and its resulting complications, including cirrhosis and hepatocellular carcinoma (HCC). Methods: We reviewed the published literature on the incidence, prevalence, trends of various etiologies of CLD and its resulting complications. In addition, we provided updated data from the Centers for Disease Control and Global Burden of Disease Study on the morbidity and mortality of CLD, cirrhosis, and hepatocellular carcinoma (HCC). Lastly, we assessed the strengths and weaknesses of available sources of data in hopes of providing important context to these national estimates of cirrhosis burden. Results: An estimated 1.5 billion persons have CLD worldwide and the age-standardized incidence of CLD and cirrhosis is 20.7/100,000, a 13% increase since 2000. Similarly, cirrhosis prevalence and mortality has increased in recent years in the United States. The epidemiology of CLD is shifting, reflecting implementation of large-scale hepatitis B vaccination and hepatitis C treatment programs, the increasing prevalence of the metabolic syndrome, and increasing alcohol misuse. Conclusions: The global burden of CLD and cirrhosis is substantial. Although vaccination, screening, and antiviral treatment campaigns for hepatitis B and C have reduced the CLD burden in some parts of the world, concomitant increases in injection drug use, alcohol misuse, and metabolic syndrome threaten these trends. Ongoing efforts to address CLD-related morbidity and mortality require accurate contemporary estimates of epidemiology and outcomes.

Original languageEnglish (US)
Pages (from-to)2650-2666
Number of pages17
JournalClinical Gastroenterology and Hepatology
Issue number12
StatePublished - Nov 2020


  • Alcohol-related
  • Hepatitis B
  • Hepatitis C
  • Liver Cancer
  • Nonalcoholic Fatty Liver Disease

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology


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