Mortality Rates of Chronic Liver Diseases from Hepatitis B and C in Africa: 1990–2030

Overview

This analysis of 47 African countries from 1990 to 2021 reveals that chronic liver disease (CLD) mortality due to hepatitis B virus (HBV) remains higher than that due to hepatitis C virus (HCV), with Western Africa experiencing the highest death counts. Projections indicate increasing CLD deaths through 2030, with most African regions unlikely to meet the global elimination targets.

Background

Chronic liver disease (CLD) is a progressive condition marked by liver inflammation and fibrosis, often culminating in cirrhosis and hepatocellular carcinoma (HCC). Viral hepatitis, particularly HBV and HCV infections, is a major cause of CLD in Africa, where approximately 100 million people were infected in 2020. Despite available HBV vaccination and HCV treatments, challenges such as limited healthcare access and the COVID-19 pandemic have hindered progress. The World Health Organization aims to eliminate viral hepatitis as a public health threat by 2030, necessitating evaluation of regional trends and burdens.

Data Highlights

Key Findings

• In 2021, HBV-related CLD deaths (81,074) and ASDR (14.2/100,000) exceeded those from HCV (60,717 deaths; 11.2/100,000).
• Western Africa recorded the highest absolute number of CLD deaths for both HBV and HCV, while Central Africa had the highest age-standardized death rates.
• Despite declines in ASDR over time, the absolute mortality burden of CLD in Africa increased significantly between 1990 and 2021.
• Projections to 2030 indicate continued increases in CLD deaths across all African regions, with the largest rises for HBV in Eastern Africa and HCV in Central Africa.
• Socioeconomic factors and limited healthcare access contribute to regional disparities in CLD burden.
• Most African regions are unlikely to meet the WHO target of a 65% reduction in viral hepatitis mortality by 2030.

Clinical Implications

Clinicians should be aware of the high and increasing burden of CLD due to HBV and HCV in Africa, particularly in Western and Central regions. Enhanced screening, early diagnosis, and access to antiviral therapies are critical to reduce mortality. Public health efforts must prioritize vaccination, treatment scale-up, and resource allocation to meet elimination goals.

Conclusion

The mortality burden of chronic liver diseases caused by HBV and HCV remains substantial and is projected to rise in Africa through 2030. Urgent international support and targeted interventions are essential to curb this trend and achieve global elimination targets.

References

1. Global Burden of Disease Collaborative Network 2021 -- Global Burden of Disease Study 2021 Results
2. World Health Organization 2019 -- Global Health Sector Strategy on Viral Hepatitis 2016–2021