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Mak LY, Liu K, Chirapongsathorn S, Yew KC, Tamaki N, Rajaram RB, Panlilio MT, Lui R, Lee HW, Lai JCT, Kulkarni AV, Premkumar M, Lesmana CRA, Hsu YC, Huang DQ. Liver diseases and hepatocellular carcinoma in the Asia-Pacific region: burden, trends, challenges and future directions. Nat Rev Gastroenterol Hepatol 2024:10.1038/s41575-024-00967-4. [PMID: 39147893 DOI: 10.1038/s41575-024-00967-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/10/2024] [Indexed: 08/17/2024]
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.
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Affiliation(s)
- Lung-Yi Mak
- The University of Hong Kong, Hong Kong, China
| | - Ken Liu
- The University of Sydney, Sydney, Australia
| | | | | | | | | | | | - Rashid Lui
- The Chinese University of Hong Kong, Hong Kong, China
| | - Hye Won Lee
- Yonsei University College of Medicine, Seoul, Korea
| | | | - Anand V Kulkarni
- Department of Hepatology, Asian Institute of Gastroenterology, Hyderabad, India
| | - Madhumita Premkumar
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Yao Chun Hsu
- Department of Medical Research, E-Da Hospital, Kaohsiung, Taiwan; School of Medicine and Graduate Institute of Medicine, I-Shou University, Kaohsiung, Taiwan
- School of Medicine and Graduate Institute of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Daniel Q Huang
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- Division of Gastroenterology and Hepatology, National University Hospital, Singapore, Singapore.
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Liu Y, Yuan X, Ji F. More expansive diagnosis and treatment are urgently needed to eliminate the global burden of HBV. LANCET REGIONAL HEALTH. AMERICAS 2024; 36:100843. [PMID: 39114765 PMCID: PMC11305271 DOI: 10.1016/j.lana.2024.100843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Revised: 07/04/2024] [Accepted: 07/09/2024] [Indexed: 08/10/2024]
Affiliation(s)
- Yi Liu
- Department of Infectious Diseases, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Xiao Yuan
- Department of Infectious Diseases, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Fanpu Ji
- Department of Infectious Diseases, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
- National & Local Joint Engineering Research Center of Biodiagnosis and Biotherapy, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Shaanxi Clinical Medical Research Center of Infectious Diseases, Xi'an, Shaanxi, China
- Key Laboratory of Surgical Critical Care and Life Support (Xi'an Jiaotong University), Ministry of Education, Xi'an, China
- Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Xi'an, China
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Wang Y, Guo X, Yuan Y. Addressing Bias and Improving Research on Gender and Racial Disparities in Hepatitis B Assessment and Treatment. J Hepatol 2024:S0168-8278(24)02428-0. [PMID: 39089632 DOI: 10.1016/j.jhep.2024.07.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2024] [Accepted: 07/19/2024] [Indexed: 08/04/2024]
Affiliation(s)
- Yongfeng Wang
- The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu, 730000, China
| | - Xiaolong Guo
- School of Stomatology, Lanzhou University, Lanzhou, Gansu, 730000, China
| | - Yuan Yuan
- Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, 200000, China.
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Shan D, Zhang G, Du Z. Considering socioeconomic status and lifestyle interventions to enhance personalized medical care for CHB in Asian patients residing in Western countries. J Hepatol 2024:S0168-8278(24)02360-2. [PMID: 38992771 DOI: 10.1016/j.jhep.2024.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Accepted: 07/05/2024] [Indexed: 07/13/2024]
Affiliation(s)
- Dan Shan
- Zhejiang Key Laboratory of Blood-Stasis-Toxin Syndrome, Zhejiang Chinese Medical University, Hangzhou, China; Department of Biobehavioural Sciences, Columbia University, New York, USA
| | - Guangji Zhang
- Zhejiang Key Laboratory of Blood-Stasis-Toxin Syndrome, Zhejiang Chinese Medical University, Hangzhou, China.
| | - Zhongyan Du
- Zhejiang Key Laboratory of Blood-Stasis-Toxin Syndrome, Zhejiang Chinese Medical University, Hangzhou, China.
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Zhang Y, Zhou Y. Enhancing Hepatitis B Management: The Role of Political, Economic, and Educational Considerations in Addressing Global Disparities. J Hepatol 2024:S0168-8278(24)00357-X. [PMID: 38797396 DOI: 10.1016/j.jhep.2024.05.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Accepted: 05/16/2024] [Indexed: 05/29/2024]
Affiliation(s)
- Yuxin Zhang
- Department of Curriculum and Instructional Technology, University of Malaya, Kuala Lumpur, Malaysia.
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Li H, Guo Q, Guo C. A Strategic Approach: Three-Tiered Management for Enhancing Global Hepatitis B Outcomes. J Hepatol 2024:S0168-8278(24)00358-1. [PMID: 38789010 DOI: 10.1016/j.jhep.2024.05.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Accepted: 05/15/2024] [Indexed: 05/26/2024]
Affiliation(s)
- Hui Li
- Department of Rheumatology and Immunology, The Second Affiliated Hospital of Shenzhen University, The People's Hospital of Baoan Shenzhen, Shenzhen, Guangdong, China.
| | - Qin Guo
- Department of Rheumatology and Immunology, The Second Affiliated Hospital of Shenzhen University, The People's Hospital of Baoan Shenzhen, Shenzhen, Guangdong, China
| | - Chengshan Guo
- Department of Rheumatology and Immunology, The Second Affiliated Hospital of Shenzhen University, The People's Hospital of Baoan Shenzhen, Shenzhen, Guangdong, China
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