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

Abstract

Background 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). 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. Aim The 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). Methods A 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. Results A 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. Conclusion Overall, 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.

How Viruses Use the VCP/p97 ATPase Molecular Machine

“…Another member of the Flaviviridae , HCV, causes hepatocellular carcinoma in a significant proportion of the chronically infected population [ 85 ]. Purification of the HCV replicase revealed an association with VCP, and p97-specific inhibitors caused abnormal localization of the NS5A protein [ 86 , 87 ].…”

The hepatocellular carcinoma's risk factors among in-hospital patients at the university-teaching hospital Yalgado Ouédraogo in Ouagadougou, Burkina Faso: A case-control study

“…The HBV infection would be responsible of half of all cases of HCC. 3 The statistics show that there are 350 million HBV chronic carriers from a total of 2 billion infected people. Sub Saharan Africa and East Asia are ranked among the highest prevalence zones where 10% of the population are chronic carriers.…”

Hepatocellular Carcinoma in Africa: Challenges and Opportunities

“…They noticed a steady increase of 1.52% each decade, but this was not statistically significant. They suggested that the incidence could be higher with statistically significant if a better screening and diagnostic capacity for HCC is done in African countries (29). The lack of basic epidemiological data regarding the actual situation of HCC is a massive constraint against better assessment and evaluation, in our opinion.…”