S2536 Divergent Trends in Global Hepatitis B, C-Related Mortality and Liver Cancer Burden: Evidence From 2 Decades of Global Burden of Disease Data (2000-2021)

Introduction: Viral hepatitis remains a leading cause of global mortality, with hepatitis B virus (HBV) and hepatitis C virus (HCV) contributing significantly to the burden of liver disease and hepatocellular carcinoma worldwide. This study aimed to analyze global trends in HBV and HCV-related mortality, including liver cancer burden, over 2 decades to inform elimination strategies and resource allocation. Methods: Global age-standardized mortality rates per 100,000 population were extracted from the Global Burden of Disease (GBD) 2021 dataset for the years 2000 to 2021. Causes included total deaths related to HBV and HCV, as well as liver cancer specifically attributable to each virus. Estimates included all ages and both sexes. Results: Over the 22-year study period, hepatitis B-related mortality declined from 9.66 to 8.23 per 100,000 population (14.9% decrease), while hepatitis C-related mortality remained relatively stable, increasing slightly from 6.48 to 6.59 per 100,000 population (1.7% increase). Hepatitis B consistently maintained higher mortality rates, with a 1.25:1 ratio compared to hepatitis C in 2021. Overall liver cancer mortality increased by 14.4% from 5.36 to 6.13 per 100,000 population. Notably, while HBV-related liver cancer mortality showed a modest decline (-1.9%), HCV-related liver cancer mortality increased substantially by 22.1% from 1.52 to 1.86 per 100,000 population. Conclusion: Despite global prevention efforts, viral hepatitis remains a significant public health challenge. The decline in hepatitis B mortality likely reflects vaccination program impact, while persistent hepatitis C mortality, particularly the 22% increase in HCV-related liver cancer deaths, highlights ongoing treatment gaps. These findings support continued investment in comprehensive viral hepatitis elimination programs with enhanced hepatitis C treatment expansion and liver cancer screening.