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
ARTICLE HIGHLIGHTS
Research background

This research delves into the evolving global landscape of hepatocellular carcinoma (HCC) mortality, specifically focusing on its correlation with hepatitis C virus (HCV) infection. Historically, HCV has significantly influenced the etiology of chronic liver disease and liver-related malignancies, notably HCC. The study highlights the increasing global burden of HCV-related HCC, a concerning trend noted across various regions worldwide. It emphasizes the need to understand these trends in the context of recent advancements in HCV treatment and changing demographic patterns, particularly given the significant public health implications and the challenges in meeting World Health Organization's goals for viral hepatitis elimination.

Research motivation

There is an urgent need to address the rising global burden of HCC secondary to HCV infection. Despite advancements in treatment, HCV remains a leading cause of HCC, with varying impacts across different regions and demographics. This study aims to identify and understand these disparities to inform targeted healthcare interventions. Addressing this issue is crucial for future research and public health policy, as it directly contributes to the World Health Organization's goal of eliminating viral hepatitis as a public health threat. Understanding the regional and demographic variations in HCC mortality rates due to HCV is essential for developing effective prevention and treatment strategies, ultimately reducing the global HCC burden.

Research objectives

This study's principal objective is to comprehensively analyze the trends in HCC mortality associated with HCV infection across various World Bank regions. The study aims to dissect these trends by gender and geographic location, offering insights into regional and demographic disparities. A critical goal is to identify areas with rising or declining mortality rates, which could signify the effectiveness of current interventions or indicate areas needing more focused attention. Realizing these objectives is significant for future research as it provides a detailed understanding of the global landscape of HCV-related HCC. This knowledge is crucial for guiding public health policies, designing targeted interventions for at-risk populations, and shaping future studies to reduce the global burden of HCC.

Research methods

Our study utilized the Global Burden of Disease database to examine HCC mortality due to HCV, focusing on different World Bank regions. We employed age-standardized mortality rates for precise demographic comparisons, analyzing these rates with Joinpoint regression software to detect trends and changes. Additionally, we used the Empirical Quantile Confidence Interval method for reliable results, despite uncertain data distributions. Our approach stands out for its regional focus and advanced statistical techniques, offering a detailed understanding of HCC mortality trends linked to HCV.

Research results

The study identified distinct regional and gender-specific trends in HCC mortality due to HCV. Key findings include a global decline in HCC mortality, with notable regional variations and gender disparities. The impact of advanced treatments like Direct-acting Antivirals (DAAs) coincided with mortality rate declines. However, North America showed an increasing trend, highlighting the need for region-specific strategies. The study underscores the importance of targeted interventions and further research to address unresolved issues in HCC mortality trends.

Research conclusions

This study introduces a theory that regional and demographic factors significantly impact HCC mortality rates from HCV infection. It postulates that global mortality decline in some regions is due to effective DAAs use, while increases in other areas might result from varying healthcare access, public health policies, and socio-economic conditions.

Research perspectives

Future research from this study should focus on: (1) Investigating the causes behind regional and gender disparities in HCC mortality from HCV, considering healthcare access and socio-economic factors; (2) Assessing the long-term efficacy of DAAs in preventing HCC in chronic HCV patients; (3) Evaluating and enhancing public health strategies in regions with increasing HCC mortality; (4) Continuing comprehensive data analysis for identifying new trends; and (5) Studying the socioeconomic impact of HCV and HCC, including treatment cost-effectiveness.