Viral hepatitis associated hepatocellular carcinoma on the African continent, the past, present, and future: a systematic review

Ottovon Bismark Dakurah,Cynthia Raissa Tchuem Tamandjou,Moleen Zunza,Tongai Gibson Maponga,Wolfgang Preiser

doi:10.1186/s12885-021-08426-y

Ottovon Bismark Dakurah, Cynthia Raissa Tchuem Tamandjou + Show 3 more

Open Access

https://doi.org/10.1186/s12885-021-08426-y

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Abstract

BackgroundHepatocellular carcinoma (HCC) is one of the leading causes of cancer-related deaths in Africa. In Africa, the major causes of HCC include chronic infection with hepatitis B virus (HBV) and/or hepatitis C virus (HCV). Knowledge of the changes in the incidence of viral hepatitis-associated HCC over time and the factors responsible for such changes is key in informing policies for the prevention of viral hepatitis-associated HCC in Africa.AimThe study aimed to systematically summarize the changes in the prevalence of viral hepatitis among HCC patients and the overall effect of the prevalence of viral hepatitis on the incidence of HCC over the past four decades in Africa (1980–2019).MethodsA literature search was conducted in MEDLINE (PubMed), Google Scholar, Science Direct, Scopus, Web of Science, and African wide web for articles published on viral hepatitis-associated HCC in Africa from 1980 to 2019. The abstracts of the articles were screened for eligibility and those meeting the inclusion criteria were retrieved and reviewed.ResultsA total of 272 studies were included in the analysis. Viral hepatitis-related HCC incidence changed by 1.17% (95% confidence interval (CI): 0.63–1.71, p < 0.001), 0.82% (95% CI: 0.45–1.18, p < 0.001), and 3.34% (95% CI: 2.44–4.25, p < 0.001) for every 1% change in the prevalence of HBV, HCV, and hepatitis D virus (HDV) respectively, per decade. The incidence of HBV-related HCC decreased by − 0.50% (95% CI: − 0.74 – − 0.25, p < 0.001) over the last 40 years, while HCV-related HCC increased.ConclusionOverall, the incidence of viral hepatitis-associated HCC has not declined, mainly due to no decline in the prevalence of HCV, HDV, and the high number of chronic hepatitis B carriers on the African continent. There is an urgent need for the allocation of resources for the implementation of treatment and preventive programs for HBV, HCV, HDV, and HCC in Africa.This systematic review is registered with PROSPERO®, number CRD42020169723.

Highlights

Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related deaths in Africa
Viral hepatitis-related HCC incidence changed by 1.17% (95% confidence interval (CI): 0.63–1.71, p < 0.001), 0.82%, and 3.34% for every 1% change in the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), and hepatitis D virus (HDV) respectively, per decade
The incidence of HBV-related HCC decreased by − 0.50% over the last 40 years, while HCV-related HCC increased

Summary

Introduction

Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related deaths in Africa. In Africa, the major causes of HCC include chronic infection with hepatitis B virus (HBV) and/or hepatitis C virus (HCV). HCC is the sixth most common cancer worldwide [1]. It is the fourth most common cancer in Africa, with differences in prevalence and etiology between North Africa and sub-Saharan Africa (SSA). This variation appears to be due to the varying prevalence of the underlying risk factors for HCC between the different regions [2]. Among the top fifteen countries with the highest incidence of HCC in the world, the African continent alone contributes six of these countries [4]

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