Liver diseases and hepatocellular carcinoma in the Asia-Pacific region: burden, trends, challenges and future directions.

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.
Competing Interests: Competing interests: L.-Y.M. served on the advisory board for Gilead Sciences and Roche Diagnostics. K.C.Y. was a speaker for Gilead and AbbVie, and received a grant supported by the Educate, Test, Treat! Programme, which was funded in part by Gilead Sciences Inc. R.L. has served as an advisory board member for Gilead Sciences, speaker for GenieBiome, and owns equity in Pfizer. J.C.-T.L. served as a speaker for Gilead Sciences, and served on an advisory board committee for Gilead Sciences and Boehringer Ingelheim. Y.C.H. has received research grants from Gilead Sciences, served on advisory committees for Gilead Sciences and Sysmex, and received lecture fees from Abbvie, Bristol-Myers Squibb, Gilead Sciences, Merck Sharp & Dohme and Novartis. D.Q.H. has served on the advisory board for Gilead Sciences and Roche Diagnostics. The other authors have no competing interests to declare.
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