The liver disease profiles provide an invaluable resource relating to one of the main causes of premature mortality nationally; a disease whose mortality rates are increasing in England, while decreasing in most EU countries. The local authority profiles will support the development of Joint Strategic Needs Assessments and work of Health and Wellbeing Boards presenting local key statistics and highlighting questions to ask locally about current action to prevent liver disease.
The website contains data for Upper Tier Local Authorities, former Government Office regions, England and where available Lower Tier Local Authorities and Integrated Care Boards.
Exact dates for updates to the profiles will be announced on the www.gov.uk statistical release calendar
Latest statistical commentary
How big an issue is liver disease?
Deaths from liver disease are increasing in England. This is in contrast to most EU countries where liver disease deaths are falling. In 2020 the number of people who died with an underlying cause of liver disease in England rose to 10,127. This rise is in contrast to other major causes of disease which have been declining. Liver disease is largely preventable. Whilst approximately 5% is attributable to autoimmune disorders (diseases characterised by abnormal functioning of the immune system), most liver disease is due to three main risk factors: alcohol, obesity and viral hepatitis.
Alcohol-related liver disease
Alcohol is the most common cause of liver disease in England. Alcohol-related liver disease accounts for over a third of liver disease deaths. The more someone drinks, the higher their risk of developing liver disease.
For further data measuring the impact of alcohol on local communities users should go to the Local Alcohol Profiles for England.
Hepatitis B virus is transmitted through contact with infected blood or other body fluids. Infection can lead to chronic disease and during the acute phase of infection the majority of people are asymptomatic; only a third of adults and a smaller proportion of children develop symptoms which may include, fever and jaundice. Most acute symptomatic infections are acquired through adult risk behaviours such as injecting drug use and sexual contact. The risk of developing chronic hepatitis B infection depends on the age at which infection is acquired. Chronic infection occurs in up to 90% of children who acquire the infection under the age of 5 years but less than 10% of people infected as adults. Without immunisation starting at birth, infants born to hepatitis B positive mothers are therefore at high risk of acquiring chronic infection. Chronic infection can lead to chronic liver disease and liver cancer. The majority (95%) of newly identified chronic hepatitis B infections are acquired overseas at birth or at a young age. Hepatitis B vaccines are available and highly effective and immunisation is recommended for high risk groups.
Hepatitis C virus is mainly transmitted through contact with infected blood. Injecting drug use is the most important risk factor for infection within the UK. People born or brought up in a country with high prevalence of chronic hepatitis C are also at risk (especially those in Africa and Asia, including Egypt, China and Pakistan), as are those who received blood transfusions in the UK prior to the introduction of HCV screening of blood in 1991. The prevalence of chronic hepatitis C infection in England is estimated to be 0.4% of adults (approximately 160,000 people).
Hepatitis C is often asymptomatic, and symptoms may not appear until the liver is severely damaged. Around 20-30% of infected people clear their infection naturally within the first six months of infection. For the remainder, hepatitis C is a chronic infection which can lead to liver disease and liver cancer. Data from the Unlinked Anonymous Monitoring survey of people who inject psychoactive drugs suggest that levels of infection in this group are high at around 50%. Around one in 20 of those who inject image and performance enhancing drugs (such as anabolic steroids and melanotan) are infected with hepatitis C.
Non-alcoholic fatty liver disease
Obesity is an important risk factor for non-alcoholic fatty liver disease (NAFLD), a term used to describe accumulation of fat within the liver that is not caused by alcohol consumption. It is usually seen in people who are overweight or obese.
Although the great majority of people with NAFLD never experience any symptoms from the condition, a minority may progress to a more serious form of the disease known as non-alcoholic steatohepatitis, which may ultimately lead to fibrosis and, in a small number of cases, cirrhosis and/or liver cancer.