{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T03:17:20Z","timestamp":1793935040383,"version":"4.8.0"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2021,12,21]],"date-time":"2021-12-21T00:00:00Z","timestamp":1640044800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2021,12,21]],"date-time":"2021-12-21T00:00:00Z","timestamp":1640044800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatology"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background and Aim<\/jats:title>\n            <jats:p>The causes of chronic liver disease (CLD) among adults have changed. Data are lacking on trends among youth. We determined the trends and changes in the global burden of CLD among adolescents and young adults using Global Burden of Disease (GBD) data (2009\u20132019).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Approach and Results<\/jats:title>\n            <jats:p>The GBD study estimation methods were used to assess CLD prevalence, incidence, and deaths (21 GBD regions). Annual percent change (APC) calculation by joinpoint regression modeling. Age groups were 15\u201319, 20\u201324, and 25\u201329 years old. Globally in 2019, the 15\u201329 group accounted for 17.2% (0.29 billion) of CLD prevalent cases, 11.2% (<jats:italic toggle=\"yes\">n<\/jats:italic> = 232,072) CLD incident cases, and 3.8% (<jats:italic toggle=\"yes\">n<\/jats:italic> = 55,515) CLD deaths. Between 2009 and 2019, CLD prevalence rate increased annually among 25\u201329 (APC = +0.41%, <jats:italic toggle=\"yes\">p<\/jats:italic> &lt; 0.001); remained stable among 20\u201324 (APC = +0.02%, <jats:italic toggle=\"yes\">p<\/jats:italic> = 0.582); and decreased among 15\u201319 (APC = \u22122.13%, <jats:italic toggle=\"yes\">p<\/jats:italic> &lt; 0.001). CLD prevalence increases were driven by the proportion with NAFLD (15\u201319: 40.8% to 52.9%, <jats:italic toggle=\"yes\">p<\/jats:italic> &lt; 0.001); 20\u201324: 57.6% to 62.7%, <jats:italic toggle=\"yes\">p<\/jats:italic> &lt; 0.001); and 25\u201329: 66.9% to 70.1%, <jats:italic toggle=\"yes\">p<\/jats:italic> &lt; 0.001); the proportion with HBV decreased across all age groups. NAFLD prevalence worsening trend (APC \u2265 0%) was global. Overall CLD death rate decreased annually in all age groups, driven by the decrease in the proportion with HBV [aged 15\u201319 (from 5.90% to 5.20%, <jats:italic toggle=\"yes\">p<\/jats:italic> &lt; 0.001); aged 20\u201324 (from 18.62% to 16.37%, <jats:italic toggle=\"yes\">p<\/jats:italic> &lt; 0.001); and aged 25\u201329 (from 28.69% to 25.28%, <jats:italic toggle=\"yes\">p<\/jats:italic> &lt; 0.001)]; from 2015 to 2019, CLD death rate for HCV (APC = +1.46%) and NAFLD (APC = +2.26%) increased.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Over the past decade, the causes of CLD among 15\u201329\u2010year\u2010olds have shifted: viral hepatitis remains the most common cause of CLD deaths, but the global burden of HBV incidence is decreasing, whereas NAFLD is the main driver for increased CLD incidence.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/hep.32228","type":"journal-article","created":{"date-parts":[[2021,11,6]],"date-time":"2021-11-06T10:48:54Z","timestamp":1636195734000},"page":"1204-1217","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":236,"title":["Global burden of NAFLD and chronic liver disease among adolescents and young adults"],"prefix":"10.1097","volume":"75","author":[{"given":"James M.","family":"Paik","sequence":"first","affiliation":[{"name":"Betty and Guy Beatty Center for Integrated Research,Inova Health System,Falls Church,Virginia,USA"},{"name":"Center for Liver Disease,Department of Medicine,Inova Fairfax Medical Campus,Falls Church,Virginia,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khaled","family":"Kabbara","sequence":"additional","affiliation":[{"name":"Betty and Guy Beatty Center for Integrated Research,Inova Health System,Falls Church,Virginia,USA"},{"name":"Center for Liver 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Columbia,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9313-577X","authenticated-orcid":false,"given":"Zobair M.","family":"Younossi","sequence":"additional","affiliation":[{"name":"Betty and Guy Beatty Center for Integrated Research,Inova Health System,Falls Church,Virginia,USA"},{"name":"Center for Liver Disease,Department of Medicine,Inova Fairfax Medical Campus,Falls Church,Virginia,USA"},{"name":"Inova Medicine,Inova Health System,Falls Church,Virginia,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,12,21]]},"reference":[{"issue":"5","key":"hep32228-bib-0001-20250824","first-page":"245","article-title":"The global, regional, and national burden of cirrhosis by cause in 195 countries and territories, 1990\u20132017: a systematic analysis for the Global Burden of Disease Study 2017","volume":"2020","year":"2017","journal-title":"Lancet Gastroenterol 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