The burden of metabolic dysfunction-associated steatotic liver disease and viral hepatitis in Saudi Arabia

AbstractBackground:Globally, viral hepatitis is decreasing, but nonalcoholic fatty liver disease (NAFLD), now metabolic dysfunction-associated steatotic liver disease (MASLD), is increasing. We assessed the burden and trends of MASLD and viral hepatitis in Saudi Arabia.Methods:Prevalence, death, and disability data due to MASLD, hepatitis C virus (HCV), and hepatitis B virus (HBV) were obtained from 2019 Global Burden of Disease (GBD) database for Saudi Arabia. Time trends were assessed by annual percent change (APC) from joinpoint regression.Results:From 2012 through 2019, MASLD prevalence in children and adults increased from 28.02% (n= 8.34 million) to 33.11% (n= 11.83 million); APC +2.43% (95% confidence interval: 2.33% to 2.54%). HBV prevalence decreased from 1.83% (n= 0.54 million) to 1.53% (n= 0.55 million); APC −1.74% (−2.66% to −0.81%). HCV prevalence stabilized from 0.72% (n= 0.21 million) to 0.73% (n= 0.26 million): APC +0.32% (−0.13% to 0.78%). Among adults (>20 years), MASLD prevalence increased from 40.64% to 43.95% (APC = +1.15%, 1.12% to 1.18%), HBV prevalence decreased from 2.67% to 2.05% (APC = −2.96%, −3.90% to −2.01%), and HCV leveled from 0.88% to 0.86% (APC = −0.30%, −0.75% to 0.16%). MASLD liver mortality rate from liver cancer and cirrhosis increased: APC of +1.15% (0.82% to 1.48%) from 1.31 to 1.43 (per 100,000). HBV and HCV liver mortality increased at slower rates (APC = +0.78%, 0.38% to 1.19%): 2.07 to 2.20 (per 100,000) and (APC = +0.55%, 0.09% to 0.89%): 6.32 to 6.61 (per 100,000), respectively.Conclusions:MASLD burden is increasing, while HBV and HCV burden is decreasing/remaining stable. Early prevention and diagnosis health policies for MASLD are needed.