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Perspectives in Clinical Hepatology
Article first published online: 29 AUG 2006
Copyright © 2006 American Association for the Study of Liver Diseases
Volume 44, Issue 3, pages 521–526, September 2006
How to Cite
Williams, R. (2006), Global challenges in liver disease. Hepatology, 44: 521–526. doi: 10.1002/hep.21347
Based on Presidential Lecture given at the Shanghai–Hong Kong International Liver Congress 2006.
Potential conflict of interest: Nothing to report.
- Issue published online: 29 AUG 2006
- Article first published online: 29 AUG 2006
- Manuscript Accepted: 19 JUL 2006
- Manuscript Received: 26 MAY 2006
Immigration, cheap air travel, and globalization are all factors contributing to a worldwide spread of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection. End-stage chronic liver disease (ESLD) as a result of co-infection with HBV/HCV is now the major cause of death for individuals who have been infected with the HIV virus. The high incidence of HCV infection in Egypt—the legacy left from the mass use of tartar emetic to eradicate schistosomiasis, as in other high prevalence areas—will take years to reduce. Steatohepatitis due to non-alcoholic fatty liver disease is developing into a new and major health problem as a result of rising levels of obesity in populations worldwide. Hepatic steatosis also has an adverse influence on the progression of other liver diseases including chronic HCV infection and alcoholic liver disease. In many countries, considerable public concern is on the rise due to increased levels of alcohol consumption adversely affecting younger and affluent age groups. With the rising prevalence of cirrhosis, primary hepatocellular carcinoma (HCC) is increasing in frequency as is that of primary intrahepatic cholangiocarcinoma. Finally, despite the successes of liver transplantation, many deserving patients are not getting transplants due to low levels of cadaver organ donation in many countries, thereby increasing pressures on the use of living donor liver transplantation. Only through a concerted effort from governments, health agencies, healthcare professionals at all levels, and the pharmaceutical industry can this grim outlook for liver disease worldwide be reversed. (HEPATOLOGY 2006;44:521–526.)