Liver diseases and hepatocellular carcinoma in the Asia-Pacific region: burden, trends, challenges and future directions

Mak LY 1 , Liu K 2 , Chirapongsathorn S 3 , Yew KC 4 , Tamaki N 5 , Rajaram RB 6 Show all authors , Panlilio MT 7 , Lui R 8 , Lee HW 9 , Lai JC 8 , Kulkarni AV 10 , Premkumar M 11 , Lesmana CRA 12 , Hsu YC 13 , Huang DQ 14

Affiliations 

  • 1 The University of Hong Kong, Hong Kong, China
  • 2 The University of Sydney, Sydney, Australia
  • 3 Phramongkutklao Hospital and College of Medicine, Royal Thai Army, Bangkok, Thailand
  • 4 Tan Tock Seng Hospital, Singapore, Singapore
  • 5 Musashino Red Cross Hospital, Tokyo, Japan
  • 6 Universiti Malaya Medical Centre, Kuala Lumpur, Malaysia
  • 7 National Kidney and Transplant Institute, Quezon City, Philippines
  • 8 The Chinese University of Hong Kong, Hong Kong, China
  • 9 Yonsei University College of Medicine, Seoul, Korea
  • 10 Department of Hepatology, Asian Institute of Gastroenterology, Hyderabad, India
  • 11 Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
  • 12 Medical Faculty Universitas Indonesia, Jakarta, Indonesia
  • 13 Department of Medical Research, E-Da Hospital, Kaohsiung, Taiwan; School of Medicine and Graduate Institute of Medicine, I-Shou University, Kaohsiung, Taiwan
  • 14 Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. [email protected]
Nat Rev Gastroenterol Hepatol, 2024 Dec;21(12):834-851.
PMID: 39147893 DOI: 10.1038/s41575-024-00967-4

Abstract

Globally, nearly half of deaths from cirrhosis and chronic liver diseases (CLD) and three-quarters of deaths from hepatocellular carcinoma (HCC) occur in the Asia-Pacific region. Chronic hepatitis B is responsible for the vast majority of liver-related deaths in the region. Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common form of CLD, affecting an estimated 30% of the adult population. Compared with people of European descent, people from the Asia-Pacific region carry more genetic variants associated with MASLD and its progression. Alcohol is a fast-growing cause of CLD and HCC in Asia as a result of the rising per-capita consumption of alcohol. Drug-induced liver injury is under-recognized and probably has a high prevalence in this region. The epidemiological and outcome data of acute-on-chronic liver failure are heterogeneous, and non-unified definitions across regions contribute to this heterogeneity. CLDs are severely underdiagnosed, and effective treatments and vaccinations are underutilized. In this Review, we highlight trends in the burden of CLD and HCC in the Asia-Pacific region and discuss the rapidly changing aetiologies of liver disease. We examine the multiple gaps in the care cascade and propose mitigating strategies and future directions.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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