Summary Cirrhosis and other chronic liver diseases resulted in 46·2 million (95% UI 43·0–49·6) global DALYs in 2019 and 1·8% (1·6–2·0) of global DALYs. Alcohol and hepatitis B and C contributed 24·2% (20·5–28·1), 23·3% (19·9–26·9), and 26·3% (22·9–30·5) of DALYs from cirrhosis, respectively.

Definition Cirrhosis and other chronic liver diseases are conditions in which liver cells are destroyed and replaced by fibrosis. Decompensated cirrhosis occurs when the liver can no longer compensate for the damage, and is marked by profound symptoms, health loss, and typically death in a few years.

Total sources
Incidence 0
Prevalence 386
Remission 0
Causes of death 3828
Other 90
Table 1: Total sources used in GBD 2019 estimation
What is new in GBD 2019?
  • •Analysis was conducted in MR-BRT of five case-series studies that reported on both NASH and cryptogenic cases as causes of cirrhosis to adjust studies only reporting on cryptogenic cases but not NASH.
  • •Bias adjustment for claims data to hospital data in the USA was estimated using MR-BRT and applied to data, lowering claims data values differentially by age.
  • •Excess mortality data (EMR) were modelled in MR-BRT by age and sex as a function of HAQ Index to provide greater guidance to DisMod-MR on the expected pattern of EMR.
  • •We added mild, moderate, and severe anaemia health states to decompensated cirrhosis based on a review of the mean haemoglobin shift of 18 g/L in people with cirrhosis.
Prevalence
Incidence
Deaths
YLLs
YLDs
DALYs
Cases
(millions)
Rate (per 100 000)
Cases
(millions)
Rate (per 100 000)
Deaths
(millions)
Rate (per 100 000)
YLLs
(millions)
Rate (per 100 000)
YLDs
(millions)
Rate (per 100 000)
DALYs
(millions)
Rate (per 100 000)
2019
Both Sexes
1690
(1560
to 1850)
20 710·1
(19 127·3
to 22 589·4)
2·05
(1·66
to 2·48)
25·3
(20·8
to 30·4)
1·47
(1·37
to 1·58)
18·0
(16·8
to 19·3)
45·5
(42·3
to 48·8)
551·9
(513·5
to 592·5)
0·694
(0·482
to 0·974)
8·6
(5·9
to 12·0)
46·2
(43·0
to 49·6)
560·4
(521·9
to 602·0)
Females
759
(697
to 830)
18 309·4
(16 833·0
to 20 079·1)
0·845
(0·688
to 1·02)
20·9
(17·2
to 25·1)
0·503
(0·459
to 0·551)
11·7
(10·7
to 12·8)
14·1
(12·9
to 15·5)
337·5
(307·6
to 370·9)
0·264
(0·182
to 0·370)
6·5
(4·4
to 9·1)
14·4
(13·2
to 15·8)
344·0
(313·7
to 376·7)
Males
932
(863
to 1010)
23 139·4
(21 465·4
to 25 005·3)
1·21
(0·964
to 1·46)
29·7
(23·9
to 36·0)
0·969
(0·899
to 1·05)
24·8
(23·1
to 26·8)
31·4
(29·0
to 34·0)
772·6
(714·0
to 838·2)
0·430
(0·297
to 0·602)
10·7
(7·4
to 15·0)
31·8
(29·4
to 34·4)
783·3
(723·9
to 849·1)
Percentage change 2010-19
Both Sexes
19·9%
(18·8
to 21·0)
2·9%
(2·0
to 3·7)
12·9%
(7·5
to 17·4)
0·6%
(–3·5
to 3·7)
9·7%
(3·5
to 15·9)
–11·6%
(–16·5
to –6·7)
4·5%
(–1·8
to 11·2)
–12·6%
(–17·9
to –7·0)
17·6%
(14·8
to 20·2)
–0·3%
(–2·5
to 1·9)
4·7%
(–1·5
to 11·3)
–12·4%
(–17·6
to –6·9)
Females
19·7%
(18·4
to 20·9)
2·1%
(1·3
to 2·9)
16·3%
(11·0
to 21·1)
2·1%
(–1·8
to 5·1)
11·8%
(4·2
to 19·5)
–10·9%
(–17·1
to –4·9)
5·4%
(–2·2
to 13·7)
–12·4%
(–18·7
to –5·5)
17·6%
(14·6
to 20·5)
–0·3%
(–2·9
to 2·1)
5·6%
(–1·9
to 13·8)
–12·2%
(–18·5
to –5·4)
Males
20·0%
(18·7
to 21·3)
3·5%
(2·4
to 4·5)
10·7%
(5·2
to 15·1)
–0·5%
(–4·9
to 2·9)
8·7%
(1·4
to 16·6)
–12·0%
(–17·8
to –5·8)
4·1%
(–3·2
to 12·5)
–12·6%
(–18·7
to –5·7)
17·5%
(14·6
to 20·4)
–0·2%
(–2·6
to 2·2)
4·3%
(–2·9
to 12·6)
–12·5%
(–18·5
to –5·6)
Numbers in parentheses are 95% uncertainty intervals.
Table 2: Global prevalence, incidence, deaths, YLLs, YLDs, and DALYs in counts and age-standardised rates for both sexes combined, females, and males, 2019, with percentage change between 2010 and 2019
Deaths YLLs YLDs DALYs
1990 10th 14th 95th 15th
2010 10th 12th 97th 14th
2019 10th 9th 94th 16th
Table 3: Rank among Level 3 causes for global deaths, YLLs, YLDs, and DALYs in 1990, 2010, and 2019, for both sexes combined
Figure 1: Composition of DALYs by constituent Level 4 causes for both sexes combined, 2019
Figure 2: Percentage of DALYs attributable to top risk factors for both sexes combined, 2019
No Legend
Figure 3: Age-standardised DALY rates for each location by SDI, both sexes combined, 2019
Figure 4: Composition of DALYs by YLLs and YLDs, age group, and sex, 2019
No Legend
Figure 5: Age-standardised DALY rates (per 100 000) by location, both sexes combined, 2019