The Burden of Liver Cirrhosis in Mortality: Results from the Global Burden of Disease Study 2017

Abstract Background: Liver cirrhosis related death is a serious threat worldwide. Rare study explored the mortality trend of liver cirrhosis caused by specific etiologies. This study aimed to demonstrated the pattern and trend based on GBD data.Methods: The liver cirrhosis mortality data was collected from GBD 2017. The ASR and EAPC were used to estimate the temporal trend of liver cirrhosis mortality by etiologies, regions, SDI and sexes.Results: Globally, mortality cases of liver cirrhosis increased 47.15%. Though the global ASR of liver cirrhosis mortality reminded stable during the period, the temporal trend varied in etiologies. The ASR of liver cirrhosis mortality caused by HCV, alcohol consumption and NASH increased with an EPAC of 0.17 (95% CI 0.14–0.20), 0.20 (95% CI 0.16–0.24), 1.00 (95% CI 0.97–1.04), respectively. A decrease trend of ASR was found in etiologies for HBV and other causes. The increase pattern was heterogeneous worldwide. The most pronounced increase trend was found in middle-high SDI regions and Eastern Europe. In contrary, the most pronounced decrease trend was found in low SDI regions and Western Sub-Saharan Africa.Conclusion: Liver cirrhosis is still a public health problem. The growth trend of liver cirrhosis mortality caused by HCV has been slowed by promoting direct-acting antiviral therapy. Unfortunately, we observed an unfavorable trend in etiologies for alcohol consumption and NASH, suggesting that more targeted and specific strategies should be established to limit alcohol consumption and promote healthy lifestyles in high risk countries, especially in middle-high SDI regions and Eastern Europe.