The Lancet–EASL Commission on liver diseases in Europe: overcoming unmet needs, stigma, and inequities

Abstract

Worldwide, liver diseases are on the rise. As an example, death rates from viral hepatitis now outnumber those from HIV/AIDS. 1 WHO http://www.who.int/hepatitis/publications/global-hepatitis-report2017/en/Date accessed: July 25, 2018 Google Scholar The Lancet Commission on liver disease in the UK provided evidence that standardised UK mortality attributable to liver diseases has risen four-fold between 1980 and 2013, 2 Williams R Ashton K Aspinall R et al. Implementation of the Lancet Standing Commission on Liver Disease in the UK. Lancet. 2015; 386: 2098-2111 Summary Full Text Full Text PDF PubMed Scopus (55) Google Scholar with liver disease likely to overtake ischaemic heart disease as the leading cause of years of working life lost. 3 Williams R Alexander G Armstrong I et al. Disease burden and costs from excess alcohol consumption, obesity, and viral hepatitis: fourth report of the Lancet Standing Commission on Liver Disease in the UK. Lancet. 2017; 391: 1097-1107 Summary Full Text Full Text PDF PubMed Scopus (100) Google Scholar In addition to varying trends in mortality (figure), 4 Pimpin L Cortez-Pinto H Negro F et al. Burden of liver disease in Europe: epidemiology and analysis of risk factors to identify prevention policies. J Hepatol. 2018; (published online May 17)https://doi.org/10.1016/j.jhep.2018.05.011 Summary Full Text Full Text PDF PubMed Scopus (336) Google Scholar , 5 European Association for the Study of the Liver https://ilc-congress.eu/wp-content/uploads/2018/hepahealth/EASL-HEPAHEALTH-Report.pdfDate accessed: July 25, 2018 Google Scholar there are substantial differences in how the management of patients is organised within health systems. The characteristics of certain at-risk populations—eg, people who inject drugs or people with alcohol use disorders—means that patients with liver disease experience stigma, resulting in a barrier to liver disease awareness and inequity in access to appropriate care. 6 Karlsen TH Tacke F “The times they are a'changin'”—positioning the European Association for the Study of the Liver in the changing landscape of hepatology. J Hepatol. 2018; 68: 873-875 Summary Full Text Full Text PDF PubMed Scopus (9) Google Scholar