Abstract

Background:

Hepatitis C virus (HCV) is one of the major causes of cirrhosis and liver cancer, leading to an enormous health burden varying by location. Investigating the disparity in changes in HCV burden between developing and developed countries could provide inferences for each other in managing HCV infection. Therefore, we aim to explore the temporal tendency of incidence, mortality, and disability-adjusted life-years (DALYs) burden in HCV in China, India and the United States, compared with the global level.

Methods:

Detail data on the total burden of HCV were collected from the Global Burden of Disease (GBD) 2019 database and stratified by sex and country. The temporal trend and association between the burden of HCV and the Socio-demographic Index (SDI) were described. Joinpoint regression models were used to calculate annual percent changes (APCs) and detect the optimal joinpoints. Decomposition was also analyzed to identify the main factors of change.

Results:

6.2 million new HCV infections (95% UI, 5.6~7.1 million), 0.54 million HCV deaths (0.48~0.61 million) and 15.3 million HCV related DALYs (13.3~17.5 million) were estimated in 2019, with an increase of 25.4%, 59.1% and 43.6% from 1990, mainly due to population growth and aging. The changing pattern was heterogeneous across countries. China experienced a sharp drop since 1990 with the highest death number in 2019 while the United States showed an upward trend during the studied period with the biggest increment among the three countries. India exhibited a fluctuated tendency at the same time with the highest DALY in 2019. Of note, an increasing trend in incidence was seen in all three countries and the world recently, especially in young people aged 0-19 years. The HCV burden was negatively associated with SDI between 0.4 and 0.7 but reversed otherwise.

Conclusion:

HCV remains a global health concern albeit tremendous progress had been made as incidence and age-standardized incident rates increased worldwide in recent years. Additionally, the mortality and DALY were still high and corresponding age-standardized rates were even increasing in some areas, suggesting that more targeted intervention should be established and accelerated to realize the 2030 elimination.