Abstract
Given significant advances in the treatment of viral hepatitis and the growing epidemic of obesity, the burden of the different types of chronic liver diseases in Bangladesh may be changing. Our aim was to assess the shift in the prevalence of different chronic liver disease etiologies in a tertiary level hospital of Bangladesh over the last 10 years. This was a retrospective observational study conducted in the Department of Hepatology in Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. It was based on data from the hospital records (2013-2016 and 2017-2022). A total of 4658 patients were included from the hospital registry between 2013 and 2022. The etiologies of chronic liver disease were compared between two time periods: (2013-2016) and (2017-2022) among these patients. A significant decrease in the prevalence of chronic hepatitis B from 51.1% (2013-2016) to 44.4% (2017-2022) (p < 0.001), chronic hepatitis C from 11.3% (2013-2016) to 10.4% (2017-2022) (p = 0.032), and non-B-non-C from 11.7% (2013-2016) to 8.6% (2017-2022) (p < 0.001) was observed. In contrast, the prevalence of nonalcoholic fatty liver disease (NAFLD/NASH) increased from 1.2% (2013-2016) to 8.1% (2017-2022) (p < 0.001); anti-HBc (total) from 3.2% (2013-2016) to 5.1% (2017-2022) (p = 0.001), and autoimmune hepatitis (AIH) from 0.2% (2013-2016) to 0.4% (2017-2022) (p = 0.038) also showed a significant increase. Over the last decade (2013-2022), NAFLD has emerged as a rapidly increasing cause of chronic liver disease in Bangladesh, whereas viral etiologies and AIH show a declining trend. Policy makers, clinicians, and stakeholders should take attention to recognize the situation and act properly.