PREVALENCE OF VARIOUS ETIOPATHOGENIC VARIANTS OF CHRONIC DIFFUSE LIVER DISEASES

Chronic diffuse liver diseases (CDLD) is a collective concept that unites diseases of various etiologies, accompanied by the development of diffuse damage to the liver parenchyma, which is characterized by deviations from the norm in biochemical markers of liver function and lasts more than 6 months.

In recent decades, CDPD has been the subject of active study by hepatologists and close attention from practicing physicians. First of all, this is due to the fact that the prevalence of liver diseases is increasing every year all over the world, and most often this pathology develops in people of working age, significantly reducing their quality of life.

Data from modern literature indicate that currently chronic liver diseases occupy a significant place among the causes of early disability and mortality of the population.

On average, there are more than 2 billion people worldwide suffering from chronic diffuse liver disease (CDLD), which is 100 times higher than the prevalence of HIV infection. In this case, the main contingent of patients becomes, as a rule, the able-bodied, socially active part of the population. CDPD include a wide range of nosologically independent inflammatory diseases of various etiologies

Thus, liver lesions of various etiologies occur in approximately the same sequence, called the “liver continuum”, the final link of which is HCC. Therefore, not only effective therapy and measures to prevent the development of CDPD themselves, but also the ability to productively intervene in this continuum are currently one of the most pressing problems of modern hepatology.

Given the paucity of epidemiological data from regions of Asia, Africa and Latin America, and the lack of consistency in regional and age-specific patterns of prevalence of chronic diffuse liver disease, further research is required to identify the global burden of the disease.

The purpose of this review was to search for literature data on the prevalence of diffuse infiltrative and inflammatory liver diseases of various etiopathogenesis.

To achieve this goal, publications of foreign authors in the Scopus and Pubmed databases were analyzed. Taking into account the depth of the search - the last 10 years, the language of publication - Russian, English, 38 full-text articles were included in the analysis

1. Aimin W., Bin F., Jie Y., Lijun Y., Lianqiang C., Yong Zh., Yuheng L., Bing Y., De W., Daiwen C. Fibroblast growth factor 21 attenuates iron overload-induced liver injury and fibrosis by inhibiting ferroptosis. Redox Biology. 2021; 46: 102131. https://doi.org/10.1016/j.redox.2021.102131

2. Alberts C.J., Clifford G.M., Georges D., Negro F., Lesi O.A., Hutin Y.J., de Martel C. Worldwide prevalence of hepatitis B virus and hepatitis C virus among patients with cirrhosis at country, region, and global levels: a systematic review. Lancet Gastroenterol. Hepatol. 2022; 7 (8): 724-

3. https://doi.org/10.1016/S2468-1253(22)00050-4

4. Allison R., Guraka A., Shawa I. T., Tripathi G., Moritz W., Kermanizadeh A. Drug induced liver injury – a 2023 update. Journal of Toxicology and Environmental

5. Health. 2023; 26 (8): 442-467. https://doi.org/10.1080/109

6. 2023.2261848

7. Aslam A., Kwo P.Y. Epidemiology and Disease Burden of Alcohol Associated Liver Disease. J. Clin. Exp.

8. Hepatol. 2023; 13 (1): 88-102. https://doi.org/10.1016/j. jceh.2022.09.001

9. Björnsson E.S. The Epidemiology of Newly Recognized Causes of Drug-Induced Liver Injury: An Update. Pharmaceuticals (Basel). 2024; 17 (4): 520. https://doi.org/10.3390/ph17040520 PMID: 38675480

10. Bril F., Al Diffalha S., Dean M., Fettig D.M. Autoimmune hepatitis developing after coronavirus disease 2019 (COVID-19) vaccine: Causality or casualty? J. Hepatol. 2021; 75 (1): 222-224. https://doi.org/10.1016/j.jhep.2021.04.003

11. Burke L., Hinkson A., Haghnejad V., Jones R., Parker R., Rowe I. A. Hepatocellular carcinoma risk scores for non-viral liver disease: A systematic review and metaanalysis. JHEP Rep. 2024; 7 (1): 101227. https://doi. org/10.1016/j.jhepr.2024.101227

12. Cao G., Jing W., Liu J., Liu M. The global trends and regional differences in incidence and mortality of hepatitis A from 1990 to 2019 and implications for its prevention. Hepatol. Int. 2021; 15 (5): 1068-1082. https:// doi.org/10.1007/s12072-021-10232-4

13. Stephens C., Robles-Diaz M., Medina-Caliz I., Garcia-Cortes M., Ortega-Alonso A., Sanabria-Cabrera J.,

14. Gonzalez-Jimenez A., Alvarez-Alvarez I., Slim M., JimenezPerez M., Gonzalez-Grande R., Fernández M.C., Casado M., Soriano G., Román E., Hallal H., Romero-Gomez M., Castiella A., Conde I., Prieto M., Moreno-Planas J.M.,

15. Giraldez A., Moreno-Sanfiel J.M., Kaplowitz N., Lucena M.I., Andrade R.J. Participating clinical centres. Comprehensive analysis and insights gained from long-term experience of the Spanish DILI Registry. J. Hepatol. 2021; 75 (1): 86-97. https://doi.org/10.1016/j.jhep.2021.01.029

16. Cooper J., Markovinovic A., Coward S., Herauf M., Shaheen A.A., Swain M., Panaccione R., Ma C., Lu C., Novak K., Kroeker K.I., Ng S.C., Kaplan G.G. Incidence and Prevalence of Primary Sclerosing Cholangitis: A Metaanalysis of Population-based Studies. Inflamm. Bowel. Dis. 2024; 30 (11): 2019-2026. https://doi.org/10.1093/ibd/ izad276

17. Devarbhavi H., Asrani S.K., Arab J.P., Nartey Y.A., Pose E., Kamath P.S. Global burden of liver disease: 2023 update. J. Hepatol. 2023; 79 (2): 516-537. https://doi. org/10.1016/j.jhep.2023.03.017

18. Miravitlles M., Herepath M., Priyendu A., Sharma Sh., Vilchez T., Vit O., Haensel M., Lepage V., Gens H., Greulich T. Disease burden associated with alpha-1 antitrypsin deficiency: systematic and structured literature reviews European Respiratory Review. 2022; 31 (163): 210-262. https://doi. org/10.1183/16000617.0262-2021

19. GBD 2017 Cirrhosis Collaborators. The global, regional, and national burden of cirrhosis by cause in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Gastroenterol. Hepatol. 2020; 5 (3): 245-266. https://doi. org/10.1016/S2468-1253(19)30349-8

20. Niu X., Zhu L., Xu Y. Global prevalence, incidence, and outcomes of alcohol related liver diseases: a systematic review and meta-analysis. BMC Public Health. 2023; 23: 859. https://doi.org/10.1186/s12889-023-15749-x

21. Griffin C., Agbim U., Ramani A., Shankar N.,

22. Kanwal F., Asrani S.K. Underestimation of CirrhosisRelated Mortality in the Medicare Eligible Population, 19992018. Clin. Gastroenterol. Hepatol. 2023; 21 (1): 223-225. https://doi.org/10.1016/j.cgh.2021.10.036

23. Hahn J.W., Yang H.R., Moon J.S., Chang J.Y., Lee K., Kim G.A., Rahmati M., Koyanagi A., Smith L., Kim M.S., López Sánchez G.F., Elena D., Shin J.Y., Shin J.I., Kwon R., Kim S., Kim H.J., Lee H., Ko J.S., Yon D.K. Global incidence and prevalence of autoimmune hepatitis, 1970-2022: a systematic review and metaanalysis. EClinicalMedicine. 2023; 65: 102280. https://doi. org/10.1016/j.eclinm.2023.102280

24. Han S., Yang Z., Zhang T., Ma J., Chandler K., Liangpunsakul S. Epidemiology of Alcohol-Associated Liver Disease. Clin. Liver Dis. 2021; 25 (3): 483-492. https://doi.org/10.1016/j.cld.2021.03.009

25. Global hepatitis report 2024: action for access in low- and middle-income countries. Geneva: World Health Organization; 2024: 242.

26. Huang D.Q., Mathurin P., Cortez-Pinto H., Loomba R. Global epidemiology of alcohol-associated cirrhosis and HCC: trends, projections and risk factors. Nat. Rev.

27. Gastroenterol. Hepatol. 2023; 20 (1): 37-49. https://doi. org/10.1038/s41575-022-00688-6

28. Ke L., Lu C., Shen R., Lu T., Ma B., Hua Y. Knowledge Mapping of Drug-Induced Liver Injury: A Scientometric Investigation (2010-2019). Front Pharmacol.

29. ; 11: 842. https://doi.org/10.3389/fphar.2020.00842

30. Kim H.Y., Yu J.H., Chon Y.E., Kim S.U., Kim

31. M.N., Han J.W., Lee H.A., Jin Y.J., An J., Choi M., Jun D.W. Prevalence of clinically significant liver fibrosis in the general population: A systematic review and metaanalysis. Clin. Mol. Hepatol. 2024; 30: 199-213. https://doi.

32. org/10.3350/cmh.2024.0351

33. Li P., Liu J., Li Y., Su J., Ma Z., Bramer W.M., Cao W., de Man R.A., Peppelenbosch M.P., Pan Q. The global epidemiology of hepatitis E virus infection: A systematic review and meta-analysis. Liver Int. 2020; 40 (7): 1516-

34. https://doi.org/10.1111/liv.14468

35. Low E., Zheng Q., Chan E., Lim S. Drug induced liver injury: East versus West – a systematic review and meta-analysis. Clin. Mol. Hepatol. 2020; 26: 142-154. https://doi.org/10.3350/cmh.2019.1003

36. Mitchell E.L., Khan Z. Liver Disease in Alpha-1 Antitrypsin Deficiency: Current Approaches and Future Directions. Curr. Pathobiol. Rep. 2018; 6 (1): 97. https:// doi.org/10.1007/s40139-018-0164-z

37. Hakim M.S., Wang W., Bramer W.M., Geng J., Huang F., de Man, R.A., Peppelenbosch M.P., Pan Q. The global burden of hepatitis E outbreaks: a systematic review. Liver Int. 2017; 37: 19-31. https://doi.org/10.1111/ liv.13237

38. NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. Lancet.

39. ; 390 (10113): 2627-2642. https://doi.org/10.1016/

40. S0140-6736(17)32129-3

41. Ovchinnikova E.V., Garbuz M.M., Ovchinnikova A.A., Kumeiko V.V. Epidemiology of Wilson's Disease and Pathogenic Variants of the ATP7B Gene Leading to Diversified Protein Disfunctions. Int. J. Mol. Sci. 2024; 25 (4): 2402. https://doi.org/10.3390/ijms25042402

42. Patel E.U., Thio C.L., Boon D., Thomas D.L., Tobian A.A.R. Prevalence of Hepatitis B and Hepatitis D Virus Infections in the United States, 2011-2016. Clin. Infect. Dis. 2019; 69 (4): 709-712. https://doi.org/10.1093/ cid/ciz001

43. Porter J.L., Rawla P. Hemochromatosis. [Updated 2024 Oct 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https:// www.ncbi.nlm.nih.gov/books/NBK430862/

44. Sato-Espinoza K., Chotiprasidhi P., Liza E., Placido-Damian Z., Diaz-Ferrer J. Evolution of liver transplantation in the metabolic dysfunction-associated steatotic liver disease era: Tracking impact through time.

45. World J. Transplant. 2024; 14 (4): 98718. https://doi. org/10.5500/wjt.v14.i4.98718

46. Shen Z.X., Wu D.D., Xia J., Wang X.B., Zheng X., Huang Y., Li B.L., Meng Z.J., Gao Y.H., Qian Z.P., Liu F., Lu X.B., Shang J., Yan H.D., Zheng Y.B., Gu W.Y., Zhang Y., Liu C.Y., Yuan W., Mei X., Li J., Li T., Zhou X.Y., Deng G.H., Chen J.J., Ma X., Li H. Prevalence and clinical characteristics of autoimmune liver disease in hospitalized patients with cirrhosis and acute decompensation in China. World J. Gastroenterol. 2022; 28 (31): 4417-4430. https:// doi.org/10.3748/wjg.v28.i31.4417

47. Stockdale A.J., Kreuels B., Henrion M.Y.R., Giorgi E., Kyomuhangi I., de Martel C., Hutin Y., Geretti A.M. The global prevalence of hepatitis D virus infection: Systematic review and meta-analysis. J.

48. Hepatol. 2020; 73 (3): 523-532. https://doi.org/10.1016/j.

49. jhep.2020.04.008

50. Younossi Z.M., Wong G., Anstee Q.M., Henry L. The Global Burden of Liver Disease. Clinical Gastroenterology and Hepatology. 2023; 21: 1978-1991. https://doi.org/10.1016/j.cgh.2023.04.015

51. Weisman M.H., Stens O., Seok K.H, Hou J.K., Miller F.W., Dillon C.F. Inflammatory Bowel Disease Prevalence: Surveillance data from the U.S. National Health and Nutrition Examination Survey. Prev. Med.

52. Rep. 2023; 33: 102173. https://doi.org/10.1016/j. pmedr.2023.102173

53. Wongtrakul W., Niltwat S., Charatcharoenwitthaya N., Karaketklang K., Charatcharoenwitthaya P. Global prevalence of advanced fibrosis in patients with type 2 diabetes mellitus: a systematic review and meta-analysis. J. Gastroenterol. Hepatol. 2024; 39 (11): 2299-2307.

54. https://doi.org/10.1111/jgh.16666

55. Global status report on alcohol and health 2018. Geneva: World Health Organization; 2018: 472.

56. Younossi Z.M., Golabi P., Paik J.M., Henry A., Van Dongen C., Henry L. The global epidemiology of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH): a systematic review. Hepatology.

57. ; 77 (4): 1335-1347. https://doi.org/10.1097/

58. HEP.0000000000000004

59. Liu Y.B., Chen M.K. Epidemiology of liver cirrhosis and associated complications: Current knowledge and future directions. World J. Gastroenterol. 2022; 28 (41): 5910-5930. https://doi.org/10.3748/wjg.v28.i41.5910