About Liver Disease

What Does Your Liver Do?

Your liver is essential to your life. It is the largest internal organ, and gland, in the body. It is about the size of a football and weighs up to 4 pounds. It is located on your right side, just under your rib cage.

The liver performs more than 500 functions, many vital, including filtering toxins from your blood, managing blood clotting, making bile to digest fat, storing and controlling blood sugar for energy (glucose/glycogen), making protein for blood plasma, storing your body’s iron, creating proteins, eliminating old and damaged red blood cells, and helping fight off infections.

What Is Liver Disease?

Liver disease is also called hepatic disease. There are many kinds of liver diseases and conditions, the most common are hepatitis virus infections, metabolic dysfunction–associated steatotic liver disease (MASLD) which is formerly known as nonalcoholic fatty liver disease (NAFLD), immune system abnormalities, inherited (genetic) conditions, cancer, damage from alcohol and substance use disorders, and others. There are more than 100 types of liver disease, most of which are in groups of subtypes.

Chronic liver disease (CLD)/cirrhosis (advanced liver scarring) are major causes of morbidity and mortality in the U.S.

Chronic liver disease (CLD) has approximately four stages:
Hepatitis (liver inflammation)
Fibrosis (scarring)
Cirrhosis (advanced liver scarring)
Liver failure

Left untreated, liver disease can lead to liver failure and liver cancer.

People with advanced liver disease and chronic viral hepatitis B should undergo regular screening for liver cancer.

Liver disease has many causes such as:
- Infections: Viruses and parasites can infect the liver. The most common infections are hepatitis viruses (hepatitis A, B, and C). Liver-damaging viruses can spread through contaminated food or water (hepatitis A), unscreened blood transfusions (generally prior to 1992), sexual contact, exposure to blood/body fluids, and other ways.
- Immune system abnormalities: Your immune system can attack parts of your body including your liver; this is called autoimmune disease. Autoimmune liver diseases include autoimmune hepatitis; primary biliary cholangitis; primary sclerosing cholangitis, and others.
- Genetics: An inherited abnormal gene can cause liver damage. Genetic liver diseases include hemochromatosis; Wilson's disease; alpha-1 antitrypsin deficiency, and others.
- Cancer and other growths: Including: hepatocellular carcinoma (liver cancer); cholangiocarcinoma (bile duct cancer); and liver adenoma (pre-cancerous mass).
- Other causes of liver disease: long-term alcohol use; fat accumulation in the liver (metabolic dysfunction–associated steatotic liver disease (MASLD), formerly known as nonalcoholic fatty liver disease (NAFLD); or steatotic liver disease (SLD), formerly known as fatty liver disease; liver congestion related to heart disease (cardiac cirrhosis or congestive hepatopathy); some prescription or other medications; some herbal compounds; toxic chemicals, and others.

What Are the Risk Factors for Liver Disease?

Risk factors include alcohol use, heavy or moderate; obesity; type 2 diabetes; high cholesterol; tattoos/body piercings; IV drug use, particularly with shared needles; blood transfusion pre-1992; exposure to blood and body fluids; unprotected sex; exposure to certain chemicals or toxins; family history of liver disease; overuse of certain pain relievers; and others.

How Many People Have Liver Disease?

4.5 million U.S. adults (1.8% of 18 yrs+) have been diagnosed with liver disease. (2018, National Health Interview Survey)

Estimates range from about 80 to 100 million people (or almost 1/3 of the population) in the U.S. having some form of liver disease, due to being overweight and having fat buildup in their liver, which is known as metabolic dysfunction–associated steatotic liver disease, (MASLD); metabolic dysfunction-associated steatohepatitis (MASH), formerly known as non-alcoholic steatohepatitis (NASH); or steatotic liver disease (SLD). One estimate cites 24% or about 1 in 4 adults. And it is on the rise.

This condition often has no symptoms, and many do not know they have it.

In 2022, 54,803 people in the U.S. died from liver disease (16.4per 100,000 population).

Chronic liver disease/cirrhosis was the 10th leading cause of death in the U.S in 2022.

Chronic liver disease was the 9th leading cause of death in 2020 for non-Hispanic Black people, aged 45-64. African American/Black men are also 60% more likely to have liver/bile duct cancer and die, compared to non-Hispanic White men. Also, African American/Black women are 30% more likely to get liver/bile duct cancer and die, compared to their White counterparts.

1.5 billion cases of chronic liver disease were estimated worldwide in 2017.

Worldwide, estimates of deaths caused by liver disease range from one to two million annually. Men account for about two-thirds of liver-related deaths.

In addition to high-risk drinking, obesity, and the opioid epidemic, increases in rates of liver disease are also driven by health and healthcare inequities, and social determinants of liver health (SDOH).

In 2022, liver disease was the 14th leading cause of death for Black people of all ages. It ranked 9th for Black people ages 35-64 years.

Who Gets Liver Disease?

Estimates of liver disease by race/ethnicity vary. The following studies show recent findings and possible trends:
- A 2016 study compared causes and prevalence rates of general liver disease/cirrhosis racial/ethnic categories, as follows:
  - Chronic liver disease rates: Japanese Americans (6.9%); Hispanic/Latino persons (6.7%); White persons (4.1%); African American/Black and Native Hawaiian persons (3.9%).
  - Cause of liver disease/cause of cirrhosis: MASLD was the most common in all groups. The most common causes of cirrhosis by ethnicity were: MASLD in Japanese American, Native Hawaiian, and Hispanic/Latino persons; alcohol-associated liver disease (ALD; alcohol-related liver disease (ARLD); alcoholic liver disease) in White persons; and hepatitis C in African American/Black persons.
- A 2017 meta-analysis of 34 studies of MASLD covering 368,569 unique patients found: MASLD prevalence was highest in Hispanic/Latino people, intermediate in Whites, and lowest in African American/Black people; risk of MASH was higher in Hispanic/Latino people and lower in African American/Black people than Whites.

A 2016 study of prevalence of chronic liver disease (CLD)/cirrhosis in a sample of Medicare claims between 1999 and 2012 (n=106,458) found: In a total of 5,783 CLD cases (3,575 CLD without cirrhosis and 2,208 with cirrhosis), the prevalence of CLD was 3.9% in Black/African American and Native Hawaiian peoples, 4.1% in Whites, 6.7% in Hispanic/Latino and 6.9% in Japanese people. MASLD was the most common cause of CLD in all ethnicities combined (52%), followed by alcohol-associated liver disease (ALD (21%). The most common cause of cirrhosis in the entire sample was MASLD. By ethnicity, MASLD was the most common cirrhosis cause in Japanese Americans, Native Hawaiians, and Hispanic/Latino peoples (32%). ALD was the most common cirrhosis cause in White people (38.2%), and hepatitis C virus was the most common cause in Black/African American people (29.8%).

A study from the American Association for the Study of Liver Disease (AASLD)’s workforce study group reported that disparities in liver disease and treatment are persistent and could be related to gender, race, geography, socioeconomic status and behaviors leading to liver disease.

An analysis of CDC data for liver disease mortality trends in the US for 1999-2020 found that liver disease mortality improved for African American/Black people but worsened for Whites. There was a rise in alcohol-related liver disease and metabolic dysfunction–associated steatotic liver disease–related deaths among Whites, while there were also continuing liver cancer and viral hepatitis disparities in the Black population.

Cirrhosis (scarring of the liver)

Cirrhosis is a long-term liver disease. Cirrhosis is scarring of the liver, when scar tissue replaces healthy tissue, causing damage and reducing the liver’s functioning. Cirrhosis is most often caused by hepatitis (liver inflammation) and other viruses; alcohol-associated liver disease (ALD); alcohol-related liver disease (ARLD); formerly alcoholic liver disease); and MASLD or steatotic liver disease.

Currently, some studies indicate that cirrhosis may increase the risk for stroke, others contradict or are inconclusive.

Rates of liver cirrhosis deaths have been consistently higher for Black/African American men and women than their White counterparts since the 1950’s.

Last updated on December 11th, 2025 at 11:22 am