The contributions of hepatitis B virus and hepatitis C virus infections to cirrhosis and primary liver cancer worldwide
Abstract
BACKGROUND/AIMS: End-stage liver disease accounts for one in forty deaths worldwide. Chronic infections with hepatitis B virus (HBV) and hepatitis C virus (HCV) are well-recognized risk factors for cirrhosis and liver cancer, but estimates of their contributions to worldwide disease burden have been lacking. METHODS: The prevalence of serologic markers of HBV and HCV infections among patients diagnosed with cirrhosis or hepatocellular carcinoma (HCC) was obtained from representative samples of published reports. Attributable fractions of cirrhosis and HCC due to these infections were estimated for 11 WHO-based regions. RESULTS: Globally, 57% of cirrhosis was attributable to either HBV (30%) or HCV (27%) and 78% of HCC was attributable to HBV (53%) or HCV (25%). Regionally, these infections usually accounted for >50% of HCC and cirrhosis. 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: n=235,000; HCV: n=211,000) and 483,000 liver cancer deaths (HBV: n=328,000; HCV: n=155,000). CONCLUSIONS: 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.
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The pattern of cirrhosis mortality rates in sub-Saharan Africa is consistent with the distribution of hepatitis B and C infection.
“a pattern consistent with the distribution of hepatitis B and C infection [45–47].”
From Liver cirrhosis mortality in 187 countries between 1980 and 2010: a systematic analysis (2014) · cites this paper as [45]
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Liver cirrhosis mortality in 187 countries between 1980 and 2010: a systematic analysis
Mokdad, A. A., Lopez, A. D., Shahraz, S., Lozano, R., Mokdad, A. H., Stanaway, J., Murray, C. J., & Naghavi, M. (2014) · BMC Medicine · doi:10.1186/s12916-014-0145-y · Cited by 1,129 · see citing works
Natural history of hepatitis C.
Westbrook, R. H., & Dusheiko, G. (2014) · Journal of Hepatology · doi:10.1016/j.jhep.2014.07.012 · Cited by 1,049 · see citing works
Bloom, K., Ely, A., Mussolino, C., Cathomen, T., & Arbuthnot, P. (2013) · Molecular Therapy · doi:10.1038/mt.2013.170 · Cited by 217 · see citing works
Remembering the forgotten non-communicable diseases
Lopez, A. D., Williams, T. N., Levin, A., Tonelli, M., Singh, J. A., Burney, P. G., Rehm, J., Volkow, N. D., Koob, G., & Ferri, C. P. (2014) · BMC Medicine · doi:10.1186/s12916-014-0200-8 · Cited by 108 · see citing works
Chen, B., Pang, L., Cao, H., Wu, D., Wang, Y., Tao, Y., Wang, M., & Chen, E. (2019) · European Journal of Gastroenterology & Hepatology · doi:10.1097/meg.0000000000001455 · Cited by 14 · see citing works
S-nitrosoglutathione reductase deficiency increases mutagenesis from alkylation in mouse liver
Leung, J., Wei, W., & Liu, L. (2013) · Carcinogenesis · doi:10.1093/carcin/bgt031 · Cited by 12 · see citing works
- Authors
- Perz, J. F., Armstrong, G. L., Farrington, L. A., Hutin, Y. J. F., & Bell, B. P.
- Affiliations
- Centers for Disease Control and Prevention (US)
- World Health Organization (CH)
- Corresponding author
- Perz, Joseph F.
- Venue
- Journal of Hepatology
- Publisher
- Elsevier BV
- Published
- 2006-10
- Volume
- 45
- Issue
- 4
- Pages
- 529-538
- ISSN
- 0168-8278 (ISSN-L)
- OpenAlex
- W2000336618
- Cited by
- 2,572
- References
- 118
- Citations by year
- 2026: 32 · 2025: 54 · 2024: 78 · 2023: 96 · 2022: 101 · 2021: 152 · 2020: 149 · 2019: 183 · 2018: 189 · 2017: 212 · 2016: 229 · 2015: 233 · 2014: 186 · 2013: 204 · 2012: 153
- FWCI
- 35.20
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Hepatology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Hepatitis B Virus Studies
- Health Sciences › Medicine › Hepatology › Hepatitis C virus research
- Health Sciences › Medicine › Hepatology › Liver physiology and pathology
- Keywords
- hepatitis B virus, hepatitis C virus, liver cirrhosis, hepatocellular carcinoma, attributable fraction, disease burden, chronic viral hepatitis, liver cancer mortality, serological markers, WHO regions
- MeSH terms
- Adult, Female, Humans, Liver Cirrhosis, Liver Neoplasms, Male, Middle Aged, Risk Factors, Global Health, World Health Organization, Prevalence, Hepatitis B, Chronic, Hepatitis C, Chronic
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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