ORIGINAL RESEARCH article
Front. Public Health
Sec. Children and Health
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1638207
This article is part of the Research TopicLiver Diseases – From Pathophysiology to New Treatment OptionsView all 3 articles
Global, regional, and national burdens of cirrhosis in childhood and adolescence during 2000 to 2021: An age-period-cohort analysis
Provisionally accepted
- Qilu Hospital, Shandong University, Jinan, China
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Abstract: Background: Cirrhosis is a major cause of morbidity and mortality worldwide, but data on the cirrhosis burden and trends in children and adolescents are sparse. Methods: Data on cirrhosis during 2000–2021, including global-, regional, and national-level numbers of cases, incidence, and prevalence, were collected by the GBD 2021 database. Trends across age groups, periods, and birth cohorts were analysed using the age–period–cohort (APC) model; epidemiological trajectories were predicted using the Bayesian APC (BAPC) model. Results: From 2000 to 2021, cirrhosis incidence decreased in the 5–9 and 10–14-year age groups but increased in the 15–19 and 20–24-year age groups. In the 15-19- and 20-24-year age groups, the respective proportion of cirrhosis due to hepatitis B decreased from 11% to 4% and from 35% to 23%, while the respective proportion due to metabolic dysfunction-associated fatty liver disease (MAFLD) increased from 87% to 93% and from 55% to 67%. Regionally, the proportion of cirrhosis attributable to HBV decreased over time, while MAFLD became the leading cause among individuals aged 15–24 years. Overall, the effects of cirrhosis among children and adolescents were consistent across socio-demographic index regions and globally, increasing with age but decreasing with period and cohort. However, the period and cohort effects of MAFLD-related cirrhosis increased regionally and globally. The BAPC model predicted that the incidence of cirrhosis among children and adolescents will continue to rise until 2050. Conclusions: During 2000–2021, the burden associated with hepatitis B declined, while the proportion of cirrhosis caused by MAFLD has been steadily increasing. The APC model revealed a consistent global trend of cirrhosis risk, increasing with age but decreasing by period and cohort.
Keywords: Public Health, cirrhosis, Global burden of disease, Children, APC model
Received: 30 May 2025; Accepted: 11 Aug 2025.
Copyright: © 2025 Yang, Yang, Tian, An, Yao, Zuo, Wu, Yang and Fan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yu-Chen Fan, Qilu Hospital, Shandong University, Jinan, China
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