Cirrhosis is an increasing cause of morbidity and mortality in
more developed countries. It is the 14th most common cause of death in adults
worldwide but the fourth in central Europe; it results in 1·03 million deaths per
year worldwide,8 170 000 per year in Europe, and 33 539 per year in the USA. Cirrhosis
is the main indication for 5500 liver transplants each year in Europe. The main
causes in more developed countries are infection with hepatitis C virus,
alcohol misuse, and, increasingly, non-alcoholic liver disease; infection with hepatitis
B virus is the most common cause in sub-

Saharan Africa and most parts of Asia.

Indian Scenario

According to
the latest WHO data published in May 2014 Liver Disease Deaths in India reached
2,16,865 or 2.44% of total deaths. The age adjusted Death Rate is 21.96 per
100,000 of population, accounting for almost one-fifth (18.3%) of the global
liver cirrhosis death toll. Liver disease is the tenth most common cause of
death in India. Cirrhosis mortality has been steadily increasing in India since
1980, as has alcohol consumption, prevalence of hepatitis B and C and diabetes
(a major risk factor for nonalcoholic fatty liver disease (NAFLD)). The etiological profile of Chronic Liver Disease (CLD) in
India highlights the epidemiological transition that the country is passing
through. HBV is the most common cause of CLD overall, while alcoholism is the
most common cause for cirrhosis of liver. There are HCV pockets in north and
northeast India while HBV is the predominant etiology in east and south India
and second most common etiology in rest of the country. There is a surge of alcohol related morbidity at a global scale
and the Indian scenario is similar, with earlier age at alcoholism, an
increasing per capita intake as well as trends of increasing ‘at risk’ drinking
as accompaniments of urbanization, globalization and a westernized lifestyle
that the country is adopting. In India, the age for alcoholic liver disease is coming down and it
mostly occurs between the ages of 30 and 40, whereas, in the West, the average
age for the disease has gone up to 45 to 55 years. Side by side, NAFLD in South Asia has been
shown to lead to significant CLD at relatively low adiposity. 

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