Acute liver failure epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Husnain Shaukat, M.D [2]

Overview

The incidence of acute liver failure in the United States is 2000-2300 cases annually. In the year 2009, the diagnosis of acute hepatic necrosis was 420 cases per 100,000 cases of all adult liver transplants in the United States. In the year 1998 to 2008, according to the United States acute liver failure (ALF) registry statistics, the most common cause of acute liver failure was acetaminophen with 46000 cases per 100,000 individuals and 12000 cases per 100,000 individuals for other drugs. Acute hepatitis B is the cause of acute liver failure in 1000 individuals per 100,000 individuals but it increases to 20,000 individuals per 100,000 individuals with hepatitis D virus co-infection. Acute liver failure is more common in women than men, and women with acute liver failure were older than men. Women are more commonly affected with autoimmune hepatitis and hepatitis E viral infection than men. The acute liver failure is seen more in the white population with 74,000 individuals per 100,000 individuals, 10,000 individuals per 100,000 individuals in the Hispanics, 3000 individuals per 100,000 individuals in the Black population and 5000 individuals per 100,000 individuals in the Asian population. The most common cause of acute liver failure in the developing countries is viral infection mainly hepatitis A and hepatitis B. The most common cause of acute liver failure in the developed world is acetaminophen toxicity. The acute liver failure secondary to hepatitis B is also on the rise in the developed world due to immigration.

Epidemiology and Demographics

  • The incidence of acute liver failure in the United States is 2000-2300 cases annually.[1]
  • In the year 2009, the diagnosis of acute hepatic necrosis was 420 cases per 100,000 cases of all adult liver transplants in the United States.[2]
  • In the year 1998 to 2008, according to the United States acute liver failure (ALF) registry statistics, the most common cause of acute liver failure was acetaminophen with 46000 cases per 100,000 individuals and 12000 cases per 100,000 individuals for other drugs.[3]
  • Acute hepatitis B is the cause of acute liver failure in 1000 individuals per 100,000 individuals but it increases to 20,000 individuals per 100,000 individuals with hepatitis D virus co-infection.[4]

Gender

  • Women are more commonly affected with autoimmune hepatitis and hepatitis E viral infection than men.[5]
  • Acute liver failure is more common in women than men and women with acute liver failure were older than men.

Race

  • The acute liver failure is seen more in the white population with 74,000 individuals per 100,000 individuals, 10,000 individuals per 100,000 individuals in the Hispanics, 3000 individuals per 100,000 individuals in the Black population and 5000 individuals per 100,000 individuals in the Asian population.[5][6]

Developed Countries

  • The most common cause of acute liver failure in the developed world is acetaminophen toxicity.[5]
  • The acute liver failure secondary to hepatits B is also on the rise in the developed world due to immigration.

Developing Countries

References

  1. Ichai P, Samuel D (2008). "Etiology and prognosis of fulminant hepatitis in adults". Liver Transpl. 14 Suppl 2: S67–79. doi:10.1002/lt.21612. PMID 18825677.
  2. McDowell Torres D, Stevens RD, Gurakar A (2010). "Acute liver failure: a management challenge for the practicing gastroenterologist". Gastroenterol Hepatol (N Y). 6 (7): 444–50. PMC 2933761. PMID 20827368.
  3. Stravitz RT, Kramer DJ (2009). "Management of acute liver failure". Nat Rev Gastroenterol Hepatol. 6 (9): 542–53. doi:10.1038/nrgastro.2009.127. PMID 19652652.
  4. Shukla NB, Poles MA (2004). "Hepatitis B virus infection: co-infection with hepatitis C virus, hepatitis D virus, and human immunodeficiency virus". Clin Liver Dis. 8 (2): 445–60, viii. PMID 15481349.
  5. 5.0 5.1 5.2 5.3 Wang FS, Fan JG, Zhang Z, Gao B, Wang HY (2014). "The global burden of liver disease: the major impact of China". Hepatology. 60 (6): 2099–108. doi:10.1002/hep.27406. PMC 4867229. PMID 25164003.
  6. Larson AM, Polson J, Fontana RJ, Davern TJ, Lalani E, Hynan LS; et al. (2005). "Acetaminophen-induced acute liver failure: results of a United States multicenter, prospective study". Hepatology. 42 (6): 1364–72. doi:10.1002/hep.20948. PMID 16317692.

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