Contributions of Hepatitis B and C to Cirrhosis and Primary Liver Cancer Worldwide

It is well known that a proportion of individuals with chronic hepatitis B virus (HBV) and/or hepatitis C virus (HCV) infection will go on to develop advanced liver disease, including cirrhosis and hepatocellular carcinoma (HCC, a form of primary liver cancer). It is estimated that end-stage liver disease accounts for 1 in 40 deaths worldwide.

As reported in the October 2006 Journal of Hepatology, researchers from the U.S. Centers for Disease Control and Prevention (CDC) attempted to quantify the global contribution of HBV and HCV to cirrhosis and liver cancer.

The researchers obtained data from representative samples of published reports on the prevalence of serologic markers for HBV and HCV infection among patients diagnosed with cirrhosis or HCC. Attributable fractions of cirrhosis and HCC due to HBV and/or HCV were then estimated for 11 World Health Organization regions.

Results

Globally, 57% of cirrhosis cases were attributable to either HBV (30%) or HCV (27%).

78% of HCC cases were attributable to either HBV (53%) or HCV (25%).

In most regions, these infections accounted for more than 50% of HCC and cirrhosis cases.

Applied to 2002 worldwide mortality estimates, these fractions represent 929,000 deaths due to chronic HBV and HCV infections, including:

- 446,000 cirrhosis deaths (HBV 235,000; HCV 211,000);
- 483,000 liver cancer deaths (HBV 328,000; HCV 155,000).

Conclusion

The authors concluded that, "HBV and HCV infections account for the majority of cirrhosis and primary liver cancer throughout most of the world, highlighting the need for programs to prevent new infections and provide medical management and treatment for those already infected."

9/12/06

Reference
J F Perz, G L Armstrong, L A Farrington, and others. The contributions of hepatitis B virus and hepatitis C virus infections to cirrhosis and primary liver cancer worldwide. Journal of Hepatology 45(4): 529-538. October 2006.