Burden of Liver Diseases: A Review from Iran

Abstract

Background: There has been an increase in the burden of liver diseases in Iran, with an increasing trend from communicable to non-communicable diseases. Almost 5400 deaths were due to chronic liver diseases in 2017. We aim to provide a concise update on the epidemiological trends of liver diseases in Iran.

Methods: Estimations of deaths, disability-adjusted life years, prevalence of chronic liver diseases and cirrhosis in Iran with its common etiologies have been reported. We investigated the major causes of chronic liver diseases in Iran, we have reported our hepatology research centers, and also we have depicted the future of liver diseases in Iran.

Results: In 2017, there was a rising trend in chronic liver diseases in Iran. The most common etiologies for chronic liver disease were chronic hepatitis B, chronic hepatitis C, and non-alcoholic steatohepatitis with highest mortalities due to liver cancer and hepatitis C. The prevalence of HBV infection has decreased from 2.9% to 1.3% with effective vaccination, but new cases are still seen due to perinatal transmission. Treatment of HCV has dramatically changed with new drugs which are being produced by local pharmaceuticals at a low cost. The main obstacle in its elimination is finding patients and linkage to care. More than a third of our population have non-alcoholic fatty liver disease in which central obesity had a stronger association than weight itself.

Conclusion: Iran has a high burden of liver diseases. The Ministry of Health has effectively controlled hepatitis B and is working towards the World Health Organizations’ goals for hepatitis C by 2030. This being said, non-alcoholic fatty liver disease is becoming a major threat to our nation’s health and quality of life.