Acute On Chronic Liver Failure Aclf Epidemiology Forecast

DelveInsight’s ‘Acute-On-Chronic Liver Failure (ACLF)–Epidemiology Forecast—2030’ report delivers an in-depth understanding of the Acute-On-Chronic Liver Failure (ACLF), historical and forecasted epidemiology in the United States, EU5 (Germany, Spain, Italy, France, and the United Kingdom), and Japan.

Geography Covered

  • The United States
  • EU5 (Germany, France, Italy, Spain, and the United Kingdom)
  • Japan

Study Period: 2018–2030

Acute-On-Chronic Liver Failure (ACLF) Disease Understanding

Acute-on-Chronic Liver Failure (ACLF) is a syndrome in patients with chronic liver disease with or without previously diagnosed cirrhosis characterized by acute hepatic decompensation resulting in liver failure (jaundice and prolongation of the international normalized ratio), and one or more extrahepatic organ failures, that is associated with increased risk for mortality within a period of 28 days and up to 3 months from onset.


The natural history of chronic liver disease in a subset of patients is progression to cirrhosis. Cirrhosis has two broad stages. The onset of jaundice, ascites, variceal bleeding, or hepatic encephalopathy heralds the onset of decompensated cirrhosis, whereas the stage where there is an absence of any of these complications is compensated cirrhosis. When viral, drug, alcohol, or ischemic hepatitis, surgery, or sepsis are superimposed upon chronic liver disease with or without either stage of cirrhosis, there is worsening of liver disease that may result in hepatic and extrahepatic organ failure. Furthermore, ACLF is classified into three groups, according to the underlying liver disease ACLF: type A ACLF (patients with underlying non-cirrhotic chronic liver disease), type B ACLF (patients with previously compensated cirrhosis), and C ACLF (patients with previous decompensated cirrhosis). Thus, ACLF is a late stage in the natural history of chronic liver disease with hepatic and extrahepatic organ failure.


Currently, treatment strategies are limited to symptomatic relief and organ support, indicating the necessity for novel biomarkers, drugs, and devices for the management of ACLF. A multidisciplinary management strategy is required to ensure the early detection of organ dysfunction. At the same time, engagement with the liver transplant community is needed to define a new allocation policy for this subset of patients. Methods to further define and characterize ACLF involve additional investigation of the metabolomics profile of patients with ACLF, while G-CSF administration and cell transplantation seem to be novel and promising therapeutic interventions to improve patient outcomes. Furthermore, prospective clinical studies are required to fully elucidate the modifiable factors that predispose patients to ACLF and improve the understanding of this devastating syndrome, while developing a personalized management plan for individual patients based on their clinical and genetic characteristics.

Acute-On-Chronic Liver Failure (ACLF) Epidemiology

The Acute-On-Chronic Liver Failure (ACLF) epidemiology division provides insights about the historical and current patient pool along with the forecasted trend for every seven major countries. It helps recognize the causes of current and forecasted trends by exploring numerous studies and views of key opinion leaders. This part of the DelveInsight report also provides the diagnosed patient pool and their trends along with assumptions undertaken.


Key Findings

The disease epidemiology covered in the report provides historical as well as forecasted Acute-On-Chronic Liver Failure (ACLF) epidemiology segmented as the Total Cases of Acute-On-Chronic Liver Failure (ACLF), Cases of Acute-On-Chronic Liver Failure (ACLF) by Grades, Organ Failure Associated with Acute-On-Chronic Liver Failure, Potential participating events of Acute-On-Chronic Liver Failure. The report includes the Incident scenario of Acute-On-Chronic Liver Failure (ACLF) in 7MM covering the United States, EU5 countries (Germany, France, Italy, Spain, and the United Kingdom), and Japan from 2018 to 2030.

Country Wise- Acute-On-Chronic Liver Failure (ACLF) Epidemiology

The epidemiology segment also provides the Acute-On-Chronic Liver Failure (ACLF) epidemiology data and findings across the United States, EU5 (Germany, France, Italy, Spain, and the United Kingdom), and Japan.

  • The total population of Acute-On-Chronic Liver Failure (ACLF) Associated in 7MM countries was estimated to be 61,026 cases in 2020 and expected to increase at a CAGR of 0.29% for the study period, i.e., 2018–2030.
  • As per the estimates, United States has the Second highest incident population of Acute-On-Chronic Liver Failure (ACLF) in 7MM.
  • Among the EU5 and 7MM countries, Germany had the highest incident population of Acute-On-Chronic Liver Failure (ACLF). On the other hand, Italy had the lowest number of cases, 1,725 cases in 2020.

Scope of the Report

  • Acute-On-Chronic Liver Failure (ACLF) report covers a detailed overview explaining its causes, symptoms, classification, pathophysiology, diagnosis, and treatment patterns
  • Acute-On-Chronic Liver Failure (ACLF) Epidemiology Report and Model provide an overview of the risk factors and global trends of Acute-On-Chronic Liver Failure (ACLF) in the seven major markets (7MM: US, France, Germany, Italy, Spain, UK, and Japan)
  • The report provides insight into the historical and forecasted patient pool of Acute-On-Chronic Liver Failure (ACLF) in seven major markets covering the United States, EU5 (Germany, Spain, France, Italy, UK), and Japan
  • The report helps recognize the growth opportunities in the 7MM concerning the patient population
  • The report assesses the disease risk and burden and highlights the unmet needs of Acute-On-Chronic Liver Failure (ACLF)
  • The report provides the segmentation of the Acute-On-Chronic Liver Failure (ACLF) epidemiology by incident Cases of Acute-On-Chronic Liver Failure (ACLF) in 7MM
  • The report provides the segmentation of the Acute-On-Chronic Liver Failure (ACLF) epidemiology by incidence of Acute-On-Chronic Liver Failure (ACLF), Total Cases of Acute-On-Chronic Liver Failure (ACLF), Cases of Acute-On-Chronic Liver Failure (ACLF) by Grades, Organ Failure Associated with Acute-On-Chronic Liver Failure, Potential participating events of Acute-On-Chronic Liver Failure in 7MM

Report Highlights

  • 10-year Forecast of Acute-On-Chronic Liver Failure (ACLF) epidemiology
  • 7MM Coverage
  • Total Cases of Acute-On-Chronic Liver Failure (ACLF)
  • Cases of Acute-On-Chronic Liver Failure (ACLF) by Grades
  • Organ Failure Associated with Acute-On-Chronic Liver Failure
  • Potential participating events of Acute-On-Chronic Liver Failure

KOL Views

We interview KOLs, and SME’s opinion through primary research to fill the data gaps and validate our secondary research. The opinion helps understand the total patient population and current treatment pattern. This will support the clients in potential upcoming novel treatment by identifying the overall scenario of the indications.

Key Questions Answered

  • What will be the growth opportunities in the 7MM concerning the patient population about Acute-On-Chronic Liver Failure (ACLF)?
  • What are the key findings of Acute-On-Chronic Liver Failure (ACLF) epidemiology across 7MM, and which country will have the highest number of patients during the forecast period (2021–2030)?
  • What would be the total number of patients with Acute-On-Chronic Liver Failure (ACLF) across the 7MM during the forecast period (2021–2030)?
  • Among the EU5 countries, which country will have the highest number of patients during the forecast period (2021–2030)?
  • At what CAGR the patient population is expected to grow by 7MM during the forecast period (2021–2030)?
  • What are the disease risk, burden, and unmet needs of Acute-On-Chronic Liver Failure (ACLF)?
  • What are the currently available treatments for Acute-On-Chronic Liver Failure (ACLF)?

Reasons to buy

The Acute-On-Chronic Liver Failure (ACLF) Epidemiology report will allow the user to -

  • Develop business strategies by understanding the trends shaping and driving the global Acute-On-Chronic Liver Failure (ACLF) market
  • Quantify patient populations in the global Acute-On-Chronic Liver Failure (ACLF) market to improve product design, pricing, and launch plans
  • Organize sales and marketing efforts by identifying the age groups and sex that present the best opportunities for Acute-On-Chronic Liver Failure (ACLF) therapeutics in each of the markets covered
  • Understand the magnitude of Acute-On-Chronic Liver Failure (ACLF) population by its incident cases
  • Understand the magnitude of Acute-On-Chronic Liver Failure (ACLF) population by its risk factors cases
  • The Acute-On-Chronic Liver Failure (ACLF) epidemiology report and model was written and developed by Masters and PhD level epidemiologists
  • The Acute-On-Chronic Liver Failure (ACLF) Epidemiology Model developed by DelveInsight is easy to navigate, interactive with dashboards, and epidemiology based on transparent and consistent methodologies. Moreover, the model supports data presented in the report and showcases disease trends over a 10-year forecast period using reputable sources

Key Assessments

  • Patient Segmentation
  • Disease Risk and Burden
  • Risk of disease by the segmentation
  • Factors driving growth in a specific patient population

1. Key Insights

2. Report Introduction

3. ACLF Epidemiology Overview at a Glance

3.1. Patient Share Distribution of ACLF in 2018

3.2. Patient Share Distribution of ACLF in 2030

4. ACLF Market Overview at a Glance

4.1. Market Share (%) Distribution of ACLF in 2018

4.2. Market Share (%) Distribution of ACLF in 2030

5. Executive Summary of Acute on Chronic Liver Failure

6. Organizations

7. SWOT Analysis of Acute-On-Chronic Liver Failure

8. Disease Background and Overview

8.1. Introduction

8.2. Heterogeneity of definitions

8.3. Types of ACLF

8.4. Clinical characteristics and pathophysiology

8.5. Diagnosis of ACLF

8.6. ACLF Biomarkers

9. Country-wise Epidemiology of Acute-On-Chronic Liver Failure (ACLF)

9.1. Assumptions and Rationale: 7MM

10. Epidemiology and Patient Population

10.1. Key Findings

10.2. 7MM Total Prevalent Patient Population of Acute-On-Chronic Liver Failure

10.3. United States

10.3.1. Cases of Acute-On-Chronic Liver Failure (ACLF) in the United States

10.3.2. Cases of ACLF by Grades in the United States

10.3.3. Organ failures associated with ACLF in the United States

10.3.4. Potential precipitating events of ACLF in the United States

10.4. Germany

10.4.1. Cases of Acute-On-Chronic Liver Failure (ACLF) in Germany

10.4.2. Cases of ACLF by Grades in Germany

10.4.3. Organ failures associated with ACLF in Germany

10.4.4. Potential precipitating events of ACLF in Germany

10.5. France

10.5.1. Cases of Acute-On-Chronic Liver Failure (ACLF) in France

10.5.2. Cases of ACLF by Grades in France

10.5.3. Organ failures associated with ACLF in France

10.5.4. Potential precipitating events of ACLF in France

10.6. Italy

10.6.1. Cases of Acute-On-Chronic Liver Failure (ACLF) in Italy

10.6.2. Cases of ACLF by Grades in Italy

10.6.3. Organ failures associated with ACLF in Italy

10.6.4. Potential precipitating events of ACLF in Italy

10.7. Spain

10.7.1. Cases of Acute-On-Chronic Liver Failure (ACLF) in Spain

10.7.2. Cases of ACLF by Grades in Spain

10.7.3. Organ failures associated with ACLF in Spain

10.7.4. Potential precipitating events of ACLF in Spain

10.8. United Kingdom

10.8.1. Cases of Acute-On-Chronic Liver Failure (ACLF) in the UK

10.8.2. Cases of ACLF by Grades in the UK

10.8.3. Organ failures associated with ACLF in the UK

10.8.4. Potential precipitating events of ACLF in the UK

10.9. Japan

10.9.1. Cases of Acute-On-Chronic Liver Failure (ACLF) in Japan

10.9.2. Cases of ACLF by Grades in Japan

10.9.3. Organ failures associated with ACLF in Japan

10.9.4. Potential precipitating events of ACLF in Japan

11. Treatment

11.1. Guidelines

11.2. APASL

11.3. EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosis

12. Case Study

13. Acute-On-Chronic Liver Failure vs. traditional acute decompensation of cirrhosis

14. Patient Journey

15. Bibliography

16. Appendix

17. Report Methodology

18. DelveInsight Capabilities

19. Disclaimer

20. About DelveInsight

List of Table

Table 1: Summary of ACLF Market, Epidemiology, and Key Events (2018–2030)

Table 2: Organization Contributing towards acute-on-chronic liver failure (ACLF)

Table 3: Characteristics of the available definitions for acute-on-chronic liver failure (ACLF)

Table 4: CLIF Consortium Organ Failure Score: simplified version of the CLIF-SOFA score

Table 5: Total Prevalent Patient Population of Acute-on-chronic liver failure (2018–2030)

Table 6: Cases of ACLF in the US 2018–2030)

Table 7: Cases of ACLF by Grades in the US (2018–2030)

Table 8: Organ failures associated with ACLF in the United States (2018–2030)

Table 9: Potential precipitating events of ACLF in the US (2018–2030)

Table 10: Cases of ACLF in Germany (2018–2030)

Table 11: Cases of ACLF by Grades in Germany (2018–2030)

Table 12: Organ failures associated with ACLF in Germany (2018–2030)

Table 13: Potential precipitating events of ACLF in Germany (2018–2030)

Table 14: Cases of ACLF in France (2018–2030)

Table 15: Cases of ACLF by Grades in France (2018–2030)

Table 16: Organ failures associated with ACLF in France (2018–2030)

Table 17: Potential precipitating events of ACLF in France (2018–2030)

Table 18: Cases of ACLF in Italy (2018–2030)

Table 19: Cases of ACLF by Grades in Italy (2018–2030)

Table 20: Organ failures associated with ACLF in Italy (2018–2030)

Table 21: Potential precipitating events of ACLF in Italy (2018–2030)

Table 22: Cases of ACLF in Spain (2018–2030)

Table 23: Cases of ACLF by Grades in Spain (2018–2030)

Table 24: Organ failures associated with ACLF in Spain (2018–2030)

Table 25: Potential precipitating events of ACLF in Spain (2018–2030)

Table 26: Cases of ACLF in the UK (2018–2030)

Table 27: Cases of ACLF by Grades in the UK (2018–2030)

Table 28: Organ failures associated with ACLF in the UK (2018–2030)

Table 29: Potential precipitating events of ACLF in the UK (2018–2030)

Table 30: Cases of ACLF in the UK (2018–2030)

Table 31: Cases of ACLF by Grades in Japan (2018–2030)

Table 32: Organ failures associated with ACLF in Japan (2018–2030)

Table 33: Potential precipitating events of ACLF in Japan (2018–2030)

List of Figures

Figure 1: Proposed unifying pathogenesis for different types of acute-on-chronic liver failure

Figure 2: The clinical course of cirrhosis

Figure 3: Immune dysfunction in ACLF

Figure 4: Pathogenesis of organ failure in ACLF

Figure 5: Cases of ACLF in the United States (2018–2030)

Figure 6: Cases of ACLF by Grades in the United States (2018–2030)

Figure 7: Organ failures associated with ACLF in the United States (2018–2030)

Figure 8: Potential precipitating events of ACLF in the United States (2018–2030)

Figure 9: Cases of ACLF in Germany (2018–2030)

Figure 10: Cases of ACLF by Grades in Germany (2018–2030)

Figure 11: Organ failures associated with ACLF in Germany (2018–2030)

Figure 12: Potential precipitating events of ACLF in Germany (2018–2030)

Figure 13: Cases of ACLF in France (2018–2030)

Figure 14: Cases of ACLF by Grades in France (2018–2030)

Figure 15: Organ failures associated with ACLF in France (2018–2030)

Figure 16: Potential precipitating events of ACLF in France (2018–2030)

Figure 17: Cases of ACLF in Italy (2018–2030)

Figure 18: Cases of ACLF by Grades in Italy (2018–2030)

Figure 19: Organ failures associated with ACLF in Italy (2018–2030)

Figure 20: Potential precipitating events of ACLF in Italy (2018–2030)

Figure 21: Cases of ACLF in Spain (2018–2030)

Figure 22: Cases of ACLF by Grades in Spain (2018–2030)

Figure 23: Organ failures associated with ACLF in Spain (2018–2030)

Figure 24: Potential precipitating events of ACLF in Spain (2018–2030)

Figure 25: Cases of ACLF in the UK (2018–2030)

Figure 26: Cases of ACLF by Grades in the UK (2018–2030)

Figure 27: Organ failures associated with ACLF in the UK (2018–2030)

Figure 28: Potential precipitating events of ACLF in the UK (2018–2030)

Figure 29: Cases of ACLF in Japan (2018–2030)

Figure 30: Cases of ACLF by Grades in Japan (2018–2030)

Figure 31: Organ failures associated with ACLF in Japan (2018–2030)

Figure 32: Potential precipitating events of ACLF in Japan (2018–2030)

Figure 33: Algorithm for management of acute-on-chronic liver failure

Figure 34: Patient Journey for ACLF

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