Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Virol. Mar 25, 2024; 13(1): 89469
Published online Mar 25, 2024. doi: 10.5501/wjv.v13.i1.89469
Global trends in hepatitis C-related hepatocellular carcinoma mortality: A public database analysis (1999-2019)
Hassam Ali, Fnu Vikash, Vishali Moond, Fatima Khalid, Abdur Rehman Jamil, Dushyant Singh Dahiya, Amir Humza Sohail, Manesh Kumar Gangwani, Pratik Patel, Sanjaya K Satapathy
Hassam Ali, Department of Internal Medicine/Gastroenterology, East Carolina University Brody School of Medicine, Greenville, NC 27834, United States
Fnu Vikash, Department of Internal Medicine, Jacobi Medical Center/Albert Einstein College of Medicine, Bronx, NY 10461, United States
Vishali Moond, Department of Internal Medicine, Saint Peter's University Hospital/Robert Wood Johnson Medical School, New Brunswick, NJ 08901, United States
Fatima Khalid, Department of Internal Medicine, Quaid-e-Azam Medical College, Bahawalpur 63100, Punjab, Pakistan
Abdur Rehman Jamil, Department of Internal Medicine, Samaritan Medical Centre, Watertown, MA 13601, United States
Dushyant Singh Dahiya, Division of Gastroenterology, Hepatology & Motility, The University of Kansas School of Medicine, Kansas City, KS 66160, United States
Amir Humza Sohail, Department of Surgery, New York University Winthrop Hospital, New York, Mineloa, NY 11501, United States
Manesh Kumar Gangwani, Department of Internal Medicine, The University of Toledo, Toledo, OH 43606, United States
Pratik Patel, Department of Gastroenterology, Mather Hospital/Hofstra University Zucker School of Medicine, NY 11777, United States
Sanjaya K Satapathy, Division of Hepatology, Department of Medicine, North Shore University Hospital, Manhasset, NY 11030, United States
Author contributions: Author Contributions: Ali H, Sohail AH, Dahiya DS, and Vikash F were responsible for the conceptualization, methodology, software development, data curation, validation, and drafting the original manuscript; Ali H, Dahiya DS, Sohail AH, Khalid F, Moond V, and Gangwani MK contributed to the critical review and editing of the manuscript and took on roles in project administration; Jamil AR, Patel P, and Satapathy SK were involved in reviewing and editing the article and provided supervision throughout the project.
Institutional review board statement: The present study did not require institutional review board oversight because Global Burden of Disease Study 2019 database is de-identified and freely accessible. It does not identify hospitals, health care providers, or patients.
Informed consent statement: Participants were not required to give informed consent to this retrospective study since the analysis of baseline characteristics used publicly available anonymized clinical data. Please contact me for any queries.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: The data used in this study is publicly available at Global Burden of Disease Study 2019 (GBD 2019) (https://ghdx.healthdata.org/gbd-2019).
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hassam Ali, MD, Academic Fellow, Academic Research, Department of Internal Medicine/Gastroenterology, East Carolina University Brody School of Medicine, 2100 Statonsburg Rd, Greenville, NC 27834, United States. alih20@ecu.edu
Received: November 2, 2023
Peer-review started: November 2, 2023
First decision: December 19, 2023
Revised: December 19, 2023
Accepted: January 18, 2024
Article in press: January 18, 2024
Published online: March 25, 2024
Processing time: 130 Days and 13.1 Hours
Abstract
BACKGROUND

Hepatitis C is the leading cause of chronic liver disease worldwide and it significantly contributes to the burden of hepatocellular carcinoma (HCC). However, there are marked variations in the incidence and mortality rates of HCC across different geographical regions. With the advent of new widely available treatment modalities, such as direct-acting antivirals, it is becoming increasingly imperative to understand the temporal and geographical trends in HCC mortality associated with Hepatitis C. Furthermore, gender disparities in HCC mortality related to Hepatitis C are a crucial, yet underexplored aspect that adds to the disease's global impact. While some studies shed light on gender-specific trends, there is a lack of comprehensive data on global and regional mortality rates, particularly those highlighting gender disparities. This gap in knowledge hinders the development of targeted interventions and resource allocation strategies.

AIM

To understand the global and regional trends in Hepatitis C-related HCC mortality rates from 1990 to 2019, along with gender disparities.

METHODS

We utilized the Global Burden of Disease database, a comprehensive repository for global health metrics to age-standardized mortality rates due to Hepatitis C-related HCC from 1999 to 2019. Rates were evaluated per 100000 population and assessed by World Bank-defined regions. Temporal trends were determined using Joinpoint software and the Average Annual Percent Change (AAPC) method, and results were reported with 95% confidence intervals (CI).

RESULTS

From 1990 to 2019, overall, there was a significant decline in HCC-related mortality rates with an AAPC of -0.80% (95%CI: -0.83 to -0.77). Females demonstrated a marked decrease in mortality with an AAPC of -1.06% (95%CI: -1.09 to -1.03), whereas the male cohort had a lower AAPC of -0.52% (95%CI: -0.55 to -0.48). Regionally, East Asia and the Pacific demonstrated a significant decline with an AAPC of -2.05% (95%CI: -2.10 to -2.00), whereas Europe and Central Asia observed an uptrend with an AAPC of 0.72% (95%CI: 0.69 to 0.74). Latin America and the Caribbean also showed an uptrend with an AAPC of 0.06% (95%CI: 0.02 to 0.11). In the Middle East and North Africa, the AAPC was non-significant at 0.02% (95%CI: -0.09 to 0.12). North America, in contrast, displayed a significant upward trend with an AAPC of 2.63% (95%CI: 2.57 to 2.67). South Asia (AAPC -0.22%, 95%CI: -0.26 to -0.16) and Sub-Saharan Africa (AAPC -0.14%, 95%CI: -0.15 to -0.12) trends significantly declined over the study period.

CONCLUSION

Our study reports disparities in Hepatitis C-related HCC mortality between 1999 to 2019, both regionally and between genders. While East Asia and the Pacific regions showed a promising decline in mortality, North America has experienced a concerning rise in mortality. These regional variations highlight the need for healthcare policymakers and practitioners to tailor public health strategies and interventions. The data serves as a call to action, particularly for regions where mortality rates are not improving, emphasizing the necessity for a nuanced, region-specific approach to combat the global challenge of HCC secondary to Hepatitis C.

Keywords: Carcinoma; Hepatocellular; Antiviral agents; Global Burden of Disease; Quality indicators; Health care; Liver neoplasms; Hepatitis C; Chronic hepatitis C

Core Tip: Hepatitis C virus (HCV) remains a crucial precursor for hepatocellular carcinoma (HCC), accounting for a significant proportion of HCC-related mortalities. Our study focused on trends from 1999 to 2019 and offers an extensive temporal analysis on the mortality rates in patients with HCV-related HCC. The data highlighted that despite advances in antiviral treatments for HCV, the mortality rates in HCC have not seen a corresponding decline. We also identified noticeable trends relating to gender, providing insights into demographic groups that are disproportionately affected. This study emphasizes the need for targeted interventions to reduce mortality rates in HCV-associated HCC, despite advancements in HCV treatment.