Burden of liver disease in Europe: Epidemiology and analysis of risk factors to identify prevention policies

EASL HEPAHEALTH Steering Committee

Research output: Contribution to journalReview articlepeer-review

216 Citations (Scopus)

Abstract

The burden of liver disease in Europe continues to grow. We aimed to describe the epidemiology of liver diseases and their risk factors in European countries, identifying public health interventions that could impact on these risk factors to reduce the burden of liver disease. As part of the HEPAHEALTH project we extracted information on historical and current prevalence and mortality from national and international literature and databases on liver disease in 35 countries in the World Health Organization European region, as well as historical and recent prevalence data on their main determinants; alcohol consumption, obesity and hepatitis B and C virus infections. We extracted information from peer-reviewed and grey literature to identify public health interventions targeting these risk factors. The epidemiology of liver disease is diverse, with variations in the exact composition of diseases and the trends in risk factors which drive them. Prevalence and mortality data indicate that increasing cirrhosis and liver cancer may be linked to dramatic increases in harmful alcohol consumption in Northern European countries, and viral hepatitis epidemics in Eastern and Southern European countries. Countries with historically low levels of liver disease may experience an increase in non-alcoholic fatty liver disease in the future, given the rise of obesity across most European countries. Liver disease in Europe is a serious issue, with increasing cirrhosis and liver cancer. The public health and hepatology communities are uniquely placed to implement measures aimed at reducing their causes: harmful alcohol consumption, child and adult obesity, and chronic infection with hepatitis viruses, which will in turn reduce the burden of liver disease.

Original languageEnglish
Pages (from-to)718-735
Number of pages18
JournalJournal of Hepatology
Volume69
Issue number3
DOIs
Publication statusPublished - Sep 2018
Externally publishedYes

Bibliographical note

Funding Information:
Helena Cortez-Pinto received lecture and advisory board fees from Intercept, Genfit, and Gilead. Francesco Negro received a research grant from Gilead and AbbVie, and is advising Gilead, AbbVie, and Merck. Jeffrey Lazarus declares speaker fees and research grants from AbbVie, Gilead Sciences and MSD, outside of this study. The other authors declare no conflict of interest.

Funding Information:
Helena Cortez-Pinto received lecture and advisory board fees from Intercept, Genfit, and Gilead. Francesco Negro received a research grant from Gilead and AbbVie , and is advising Gilead, AbbVie, and Merck. Jeffrey Lazarus declares speaker fees and research grants from AbbVie, Gilead Sciences and MSD, outside of this study. The other authors declare no conflict of interest.

Funding Information:
This work was supported by EASL funding.

Publisher Copyright:
© 2018 European Association for the Study of the Liver

Keywords

  • Alcohol
  • Epidemiology
  • Hepatitis
  • Liver disease
  • Obesity
  • Policy
  • Viral

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