亚太地区拥有全球一半以上的人口，2015年占全球肝病死亡62.6%，54.3%的肝硬化死亡，72.7%的肝细胞癌死亡和全球急性病毒性肝炎负担超过2/3在这个地区发生。慢性乙型肝炎（HBV）感染占该地区肝硬化死亡的一半以上，其次是饮酒（20.8％），非酒精性脂肪肝病（NAFLD；12.1％）和慢性乙型肝炎病毒（HCV；15.7％）。2015年，该地区肝细胞癌病例中约有一半由HBV引起。预防病毒性肝病相关的肝病需要提高饮用水和卫生设施的接触率。虽然所有国家都实施了新生儿HBV疫苗计划，但在一些国家婴儿接种率极低。血液和组织的筛查测试、献血者回忆政策和危害减少策略在大多数国家处于初步阶段。许多政府已将HBV和HCV药品列入其基本药物清单，这些药物的非专利版本的可获得性已降低成本。努力消除病毒性肝炎作为公共卫生威胁，加上各国的人均饮酒量快速增加和肥胖症流行，预期在不久的将来会改变亚太地区的肝病谱。通过政府政策限制饮酒量和推广不那么有害的饮酒模式，可控制与酒精相关的肝病负担，这在某些国家已经实施，但需要更加严格地执行。需要采取措施控制肥胖和NAFLD，包括制定促进健康生活方式和监管食品行业的政策。亚太地区不足的基础设施和缺乏的接受肝病培训的医务人员也是需要解决的问题。迄今为止，大多数政府对肝病的政策反应一直是不充分和资金不足的。必须重新关注预防、早期检测、及时转诊和研究引入和改善健康干预措施的最佳方法，以减轻亚太地区肝病负担。

The Asia-Pacific region is home to more than half of the global population and accounted for 62·6% of global deaths due to liver diseases in 2015. 54·3% of global deaths due to cirrhosis, 72·7% of global deaths due to hepatocellular carcinoma, and more than two-thirds of the global burden of acute viral hepatitis occurred in this region in 2015. Chronic hepatitis B virus (HBV) infection caused more than half of the deaths due to cirrhosis in the region, followed by alcohol consumption (20·8%), non-alcoholic fatty liver disease (NAFLD; 12·1%), and chronic infection with hepatitis C virus (HCV; 15·7%). In 2015, HBV accounted for about half the cases of hepatocellular carcinoma in the region. Preventive strategies for viral hepatitis-related liver disease include increasing access to clean drinking water and sanitation. HBV vaccination programmes for neonates have been implemented by all countries, although birth-dose coverage is extremely suboptimal in some. Availability of screening tests for blood and tissue, donor recall policies, and harm reduction strategies are in their initial stages in most countries. Many governments have put HBV and HCV drugs on their essential medicines lists and the availability of generic versions of these drugs has reduced costs. Efforts to eliminate viral hepatitis as a public health threat, together with the rapid increase in per-capita alcohol consumption in countries and the epidemic of obesity, are expected to change the spectrum of liver diseases in the Asia-Pacific region in the near future. The increasing burden of alcohol-related liver diseases can be contained through government policies to limit consumption and promote less harmful patterns of alcohol use, which are in place in some countries but need to be enforced more strictly. Steps are needed to control obesity and NAFLD, including policies to promote healthy lifestyles and regulate the food industry. Inadequate infrastructure and insufficient health-care personnel trained in liver diseases are issues that also need to be addressed in the Asia-Pacific region. The policy response of most governments to liver diseases has thus far been inadequate and poorly funded. There must be a renewed focus on prevention, early detection, timely referral, and research into the best means to introduce and improve health interventions to reduce the burden of liver diseases in the Asia-Pacific region.Copyright © 2020 Elsevier Ltd. All rights reserved.