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. 2019 Jan-Feb;9(1):50-55.
doi: 10.1016/j.jceh.2018.02.006. Epub 2018 Feb 16.

The Changing Face of Hepatocellular Carcinoma: Forecasting Prevalence of Nonalcoholic Steatohepatitis and Hepatitis C Cirrhosis

Osmanuddin Ahmed  1 , Lisa Liu  1 , Antony Gayed  1 , Amanjit Baadh  1 , Mikin Patel  2 , Jordan Tasse  1 , Ulku Turba  1 , Bulent Arslan  1
Affiliations

The Changing Face of Hepatocellular Carcinoma: Forecasting Prevalence of Nonalcoholic Steatohepatitis and Hepatitis C Cirrhosis

Osmanuddin Ahmed et al. J Clin Exp Hepatol. 2019 Jan-Feb.

Abstract

Background/objectives: The purpose of this research is to analyze the past and forecast the future prevalence of Hepatitis C Virus (HCV) and Nonalcoholic Steatohepatitis (NASH) and their respective contribution to Hepatocellular Carcinoma (HCC) incidence in the setting of novel anti-viral agents and rising obesity rates in the United States.

Methods: Existing data of HCV and NASH prevalence in the United States utilizing the National Health and Nutrition Examination Survey (NHANES) and Organ Procurement and Transplantation Network (OPTN) was collected and analyzed to project future prevalence trends.

Results: Prevalence of NASH and HCV are expected to increase and decline respectively over the next two decades with alcoholic cirrhosis expected to stay relatively unchanged. The estimated prevalence of NASH equaled and overtook the projected prevalence of HCV in 2007 at approximately 3 million persons. Estimates of NASH's contribution to HCC overtook HCV-HCC in 2015 at an approximately 25 million persons. Projection models suggest HCV prevalence declining to 1 million active cases by 2025, while NASH potentially increases to 17-42 million depending on a linear or exponential trendline. Projections of NASH-HCC similarly outpace HCV-HCC by 2025 with 45 million or 106 million (linear, exponential) versus 18 million persons respectively.

Conclusions: The future prevalence of HCV and NASH are expected to become further divergent with NASH emerging as the major contributor of cirrhosis and HCC in the United States.

Keywords: HCC, Hepatocellular Carcinoma; HCV, Hepatitis C Virus; NASH, Nonalcoholic Steatohepatitis; NHANES, National Health and Nutrition Examination Survey; OPTN, Organ Procurement and Transplantation Network; epidemiology; interventional oncology; liver; obesity.

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Figures

Figure 1
Figure 1
Predicted NASH and HCV progression to HCC in the United States (2004–2025).
Figure 2
Figure 2
Predicted NASH and HCV prevalence in the United States (2004–2025).
See this image and copyright information in PMC

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