Liver Disease in Aboriginal and Torres Strait Islander People

Aboriginal and Torres Strait Islander people have a substantially higher prevalence of liver disease than non-Indigenous Australians. Cirrhosis and its complications were the sixth leading cause of mortality for Aboriginal and Torres Strait Islander people in 2020. Liver disease has been estimated to be the third leading cause of the mortality gap between Aboriginal and Torres Strait Islander and non-Indigenous people due to chronic disease, accounting for 11% of this gap. While current trends show reducing mortality rates for Aboriginal and Torres Strait Islander people for conditions including circulatory disease, diabetes and kidney disease, there are no data to suggest a similar decline for liver disease. This review highlights the common causes of liver disease affecting Aboriginal and Torres Strait Islander people, which include hepatitis B, hepatitis C, alcohol related liver disease, metabolic dysfunction-associated fatty liver disease, and cirrhosis and its complications including hepatocellular carcinoma. Current treatments including liver transplantation as well as suggestions for improving detection, treatment and access to liver care will also be discussed. Recent revolutions in the detection and treatment of liver disease make efforts to improve access to treatment and outcomes an urgent priority for Aboriginal and Torres Strait Islander people.