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Updated: Apr 7, 2026
Author Spotlight: Advancements and Challenges in Hepatitis B Virus Detection
Published on: December 15, 2023
World-wide relative contribution of hepatitis B and C viruses in hepatocellular carcinoma
Catherine de Martel1, Delphine Maucort-Boulch1,2,3,4, Martyn Plummer1
1International Agency for Research on Cancer, Lyon, France.
Insights
Hepatitis B virus (HBV) and hepatitis C virus (HCV) are leading causes of liver cancer (HCC). A global review found HBV predominates in Asia and Africa, while HCV is more common in Europe and the Americas, with increasing HCV contributions to HCC.
Area of Science:
- Hepatology
- Oncology
- Infectious Diseases
Background:
- Hepatocellular carcinoma (HCC) is a major global health concern.
- Hepatitis B virus (HBV) and hepatitis C virus (HCV) are primary drivers of HCC worldwide.
- Understanding the etiological contribution of HBV and HCV to HCC is crucial for public health strategies.
Purpose of the Study:
- To systematically review and assess the global burden of HBV and HCV in HCC.
- To identify regional variations and temporal trends in HBV- and HCV-associated HCC.
- To determine the relative prevalence of HBV and HCV in HCC cases across different geographic areas.
Main Methods:
- Systematic review of case series published up to 2014.
- Inclusion criteria: studies reporting seroprevalence of HBsAg and anti-HCV in at least 20 adult HCC cases.
- Exclusion criteria: studies using first-generation ELISA for HCV; data from Oceania, parts of Africa, Eastern Europe, and Central Asia were limited.
Main Results:
- 119,000 HCC cases from 260 studies across 50 countries were analyzed.
- HBV is predominant in Asian and African countries; HCV is more prevalent in European and American countries.
- Increasing HCV contribution to HCC observed in the US, Brazil, and Germany since 2000; declining HCV proportion noted in Japan and Italy.
Conclusions:
- HBV and HCV remain the dominant causes of HCC globally.
- A significant and growing proportion of HCC cases are attributable to HCV in numerous countries.
- Regional disparities in HBV/HCV etiology of HCC necessitate tailored prevention and treatment approaches.
Unlabelled:
Hepatitis B virus (HBV) and hepatitis C virus (HCV) are major causes of hepatocellular carcinoma (HCC). In order to assess the relative contribution of HBV and HCV to HCC worldwide, and identify changes over time, we conducted a systematic review of case series published up to the year 2014. Eligible studies had to report seroprevalence of both hepatitis B surface antigen (HBsAg) and antibodies to HCV (anti-HCV), alone and in combination, for at least 20 adult HCC cases. Studies using a first-generation enzyme-linked immunosorbent assay test for HCV were excluded. A total of 119,000 HCC cases in 260 studies were included from 50 countries. Most European and American countries show a preponderance of HCV over HBV and a substantial fraction of viral marker-negative cases. Asian and African countries generally show a predominance of HBV. The fraction of HCV-positive HCC cases is substantial in Taiwan, Mongolia, Japan, and Pakistan as well as in Western-Central Asia and Northern Africa. No eligible studies were available in Oceania, large parts of Africa, Eastern Europe, and Central Asia. The United States, Brazil, and Germany show evidence of higher prevalence of HCV in HCC since the year 2000. Conversely, Japan and Italy show a decline in the proportion of HCV-positive HCC.
Conclusion:
HBV and HCV are predominant causes of HCC in virtually all world areas, with a growing fraction of HCC cases in several countries attributable to HCV.
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