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Facts About Liver Disease

Comparative mortality rates

Liver mortality map 1970 to 2010











Graph: Data sourced from the Lancet Liver Campaign report: Addressing liver disease in the UK

(Data were normalised to 100% in 1970, and subsequent trends plotted using the software Statistical Package for the Social Sciences. Data are from the WHO-HFA database.4 Analysed by Nick Sheron September, 2013).

Key facts

  • Liver disease is the only major cause of death still increasing year-on-year
  • Liver disease is the fifth ‘big killer’ in England & Wales, after heart, cancer, stroke and respiratory disease
  • 16,087 people in the UK died from liver disease in 2008, a 4.5% increase since 2007.
  • This includes 13,805 people in England and Wales, 1,903 in Scotland4 and 379 in Northern Ireland
  • Twice as many people now die from liver disease as in 1991
  • Liver disease kills more people than diabetes and road deaths combined.

These statistics are not comprehensive, due to two major reasons for under recording: the stigma associated with liver disease and attempts to avoid distress to the bereaved, and attribution of liver deaths to other codes as liver disease frequently causes multiple organ dysfunction.

It is important to remember that as people can survive with 70% liver damage, there is a substantial burden of morbidity from liver disease, a high cost to the NHS and a huge economic and human cost from liver-related ill health.

Alcohol and Liver Disease

  • The cost to the NHS of alcohol misuse has been estimated at £2.7 billion each year. 1
  • In 2007 4,580 people died in England and Wales from alcohol related liver disease. 2  There was a 41% increase in the number of deaths from alcohol related liver disease between 1999 and 2005 and in the last 30 years, mortality has risen over 450% in the UK. 3
  • In 2007 in total, there were 5,732 alcohol-related deaths in men and 2,992 in women. 4
  • The process is silent, but when liver disease has developed it presents as an acute illness with a 25-50% immediate mortality.
  • Hospital admissions for alcohol related disease, including alcohol related liver disease, have more than doubled since 1995/6 and between 2002/3 and 2006/7 there was a 71% increase .There are over 800,000 hospital admissions directly related and attributable to alcohol each year.6
  • In Scotland, in 2007/8 there was a 400% increase in patients discharged from hospital with alcohol related liver disease (6,817) compared to 1996. In 2006-7, 1,094 children aged  under 18 were admitted to hospital with an alcohol-related diagnosis. Treatment for alcohol related conditions in Scotland costs over £1m a day. 8
  1. Department of Health: Safe, Sensible, Social - Consultation on further action Impact Assessments 22 July 2008
  2. ONS
  3. Calling time: The nation’s drinking as a major health issue, Academy of Medical Sciences, 2004/The human cost of alcohol misuse BMA 2009
  4. ONS News release 27 01 09
  5. North West Public Health Observatory (2008), ‘Local Alcohol Profiles for England’.
  6. CMO Annual  Report Passive Drinking 2008  p.20 and Department of Health: Safe, Sensible, Social - Consultation on further action Impact Assessments 22 July 2008
  7. ISD SMR01, 11 June 2007
  8. The costs of alcohol use and misuse in Scotland, Scottish Government 2008

 Hepatitis B

  • Hepatitis B is one of the world’s most common and serious infectious diseases and the most common liver infection in the world.
  • Hepatitis B affects 2 billion people worldwide. 
  • Worldwide more than 350 million people have chronic or lifelong hepatitis B infections. 
  • Hepatitis B kills between 500,000 and 700,000 people worldwide each year from liver cancer or liver cirrhosis. 326,000 people are estimated to have hepatitis B in the UK according to a 2007 independent report 
  • The Department of Health estimated in 2002 that approximately 180,000 people in Britain have chronic hepatitis B infections. A 2007 independent report has estimated a much higher figure of 326,000
  • In England and Wales, new hepatitis B notifications to the authorities increased from 487 in 1992 to 1,151 in 2003 - a 135% increase. Collecting data for hepatitis B in the UK is under review but 600 to 800 new cases of acute hepatitis B are recorded each year. However, most infections are not diagnosed at the acute stage and many chronic carriers are unaware of their infection.
  • In 2007 there were 475 acute and chronic cases reported in Scotland (an increase on previous average annual total of 357) and 106 in Northern Ireland (78 cases were recorded in 2006). 
  • There are approximately 1,300 cases of symptomatic acute cases of hepatitis B each year, however approximately two-thirds of hepatitis B cases are asymptomatic, which means many cases are often undiagnosed leading to under-reporting of the disease.
  • HBV can survive in excess of a week in dried blood e.g. blood stains on table tops and razor blades.
  3. WHOestimates: and Hepatitis B:Out of the shadows (Foundation for Liver Research); Rising Curve: Hepatitis B Infection in the UK. November 2007, Hepatitis B Foundation UK
  4. Rising Curve: Hepatitis B Infection in the UK. November 2007, Hepatitis B Foundation UK
  5. Green Book/ HPA: Hep B3 Study. National Report:Annual Data for 2005 and 2006 (2007)
  6. HPA: Shooting Up: Infections among injecting drug user in the United Kingdom 2007, An update / Health in Scotland Report 2007, CMO Annual Report (2008) Public Health Scotland CMO report 2015.pdf

 Hepatitis C

  • An estimated five out of every six people with chronic hepatitis C are unaware of their infection. 
  • According to the Health Protection Agency, around 191,000 people aged 15-59 have hepatitis C (2003) and 142,000 in this age group have chronic disease. 2
  • Some estimates are that up to 466,000 people have the virus in the UK. 3  
  • The number of new laboratory confirmed diagnoses rose to 7,540 in 2007, 12 per cent higher than the number of new diagnoses in 2006. Only a small proportion of total infections are thought to be laboratory-confirmed, as the majority of people are unaware of their infection and are not tested.
  • The estimated HCV incidence in England is 12,995 and the total prevalence in England  is 201,054. 
  • The number of people with HCV-related end stage liver disease continues to rise.  Between 1996 and 2005 the number of new cases increased by 100% and is predicted to increase to 2,670 by 2015. 6
  • The World Health Organisation (WHO) reports that approximately 3% of the world’s population are infected with hepatitis C. 170 million people are chronically infected and 3-4 million are newly infected each year.
  • Around one in five people with hepatitis C will rid themselves of the virus naturally. The remainder will develop chronic infection and of these 5-15% will develop cirrhosis within the next 20 years. 7
  • In 2007, only 29% of diagnosed patients were treated with NICE approved antiviral therapy. 8
  • The number of people with HCV-related cirrhosis is expected to more than double to 8,280 by 2015 9
  • The future burden of hepatitis C on the NHS is estimated to reach up to £8 billion in the next 30 years. 10
  1. Hepatitis C Action Plan, Department of Health 2004
  2. Hepatitis C in the UK (HPA Annual Report 2008)
  3. Losing the fight against hepatitis C. London: The Hepatitis C Trust and the University of Southampton, 2005
  4. Hepatitis C in the UK (HPA Annual Report 2008)
  5. Hepatitis C in England: an analysis of the implementation of NICE guidance on the treatment of hepatitis C, London: Roche Products Ltd, 2009
  6. Hepatitis C in England: An update (HPA Annual Report 2007)
  7. Freeman AJ, Dore GJ, Law MG, Thorpe M, Von Overbeck J, Lloyd AR, et al. Estimating progression to cirrhosis in chronic hepatitis C virus infection. Hepatology 2001;34(4 Pt 1):809-16.
  8. The Hepatitis C Trust, Out of Control: An audit of Strategic Health Authority hepatitis C governance. July 2009
  9. Hepatitis C in England: The Health protection Agency Annual Report , London: Health Protection Agency, 2007
  10. Losing the fight against hepatitis C. London: The Hepatitis C Trust and the University of Southampton, 2005

Liver Transplants

  • At the end of March 2009 there were 338 people registered for a liver transplant. From 1st April 08 to 29th March 2009 there were 644 liver transplants from deceased donors.
  • In 2007-8, 268 people remained on the active waiting list. There were a total of 1,121 patients waiting on the list during 2007-8.  58% of these received transplants while 25% were still waiting at 31st March 2008.
  • Between 2002 and 2007, there were a total of  3333 liver transplants including liver/kidney, liver/pancreas and lung/liver operations.
  • Regional information on liver transplantation
  • The top three causes were alcohol related cirrhosis (527), hepatitis C related cirrhosis (412) and primary biliary cirrhosis (281).
  • NHSBT Annual report on Liver Transplantation: Annual Report on Liver Transplantation ye 310317
  • All stats from NHSBT

Please see our transplant section for further information.

Obesity and Non-Alcohol Related Fatty Liver Disease (NAFLD)

  • 60.8% of adults (16 or over) in England are overweight or obese, 24% of these obese. 1
  • The cost to the NHS is estimated to be £4.2 billion and will be double that by 2050. 
  • The Health Survey for England (HSE) data shows that in 2007, 60.8% of adults (aged 16 or over) in England were overweight or obese, out of these 24% were obese.
  • Both obesity and type 2 diabetes have been seen as being global epidemics. Obesity is not only associated with NAFLD/NASH, but with progression of hepatitis C and of alcohol related liver disease.
  • NAFLD is considered to be the most common liver problem in the western world with 20-30% of the population affected, the vast majority undiagnosed.
  1. The Health Survey for England 2016 - published December 2017