Evolving landscape of hepatitis C research in the Eastern Mediterranean Region: A comprehensive bibliometric analysis from 2004 to 2024

Abstract

Background: Hepatitis C presents a significant public health challenge in the Eastern Mediterranean Region (EMR), which has the highest global disease burden. This study aims to provide a comprehensive overview of Hepatitis C-related research in the EMR using bibliometric analysis.

Methods: Between January 1, 2004, and December 31, 2024, a bibliometric search was conducted using the Scopus database to identify Hepatitis C-related publications from countries in the EMR. The analysis was performed using the R-based Bibliometrix tool, which examined research productivity trends, recent themes, thematic evolution, and co-occurrence networks of terms.

Results: The analysis identified 9,357 publications with an 8.06% annual growth rate and 170,021 total citations. Two distinct research clusters emerged: treatment regimens and epidemiological studies. Thematic evolution revealed a consistent focus on cirrhosis and hepatocellular carcinoma, while treatment approaches shifted from interferon-based therapies to direct-acting antivirals. Analysis of genotype-related research highlighted the regional importance of Genotype 4. Recent trends indicated integrating Hepatitis C research with broader public health concerns like COVID-19.

Conclusions: The Hepatitis C research landscape in the EMR is dynamic and maturing, characterized by substantial growth, diversification of research themes, and adoption of advanced treatment strategies. The findings underscore the need for continued multidisciplinary efforts and a focus on emerging themes to advance Hepatitis C management further and improve regional patient outcomes.

Keywords: Bibliometric analysis; Eastern Mediterranean Region; Hepatitis C; Liver cirrhosis; Liver neoplasms; Public health.

Fig. 1

Co-occurrence network of Hepatitis C research in the Eastern Mediterranean Region in Scopus from 2004 to 2024. The network reveals two primary clusters: a blue cluster focused on antiviral treatments (sofosbuvir, pegylated interferon, and direct-acting antivirals) and a red cluster encompassing epidemiological and clinical manifestations/complications aspects (prevalence, risk factors, hepatocellular carcinoma, cirrhosis)

Fig. 2

Thematic map of Hepatitis C research in the Eastern Mediterranean Region in the entire period. The map plots research themes across four quadrants: Niche Themes (cirrhosis, hepatocellular carcinoma); Motor Themes (hepatitis B, HIV, prevalence); Basic Themes (hepatitis C, direct-acting antivirals); and Emerging/Declining Themes (sofosbuvir, ribavirin)

Fig. 3

Thematic evolution of Hepatitis C research themes in the EMR: A Scopus-based analysis from 2004 to 2024, divided into four periods, revealing Hepatitis C’s evolution from basic to motor theme while showing treatment shifts from interferons to direct-acting antivirals. Cirrhosis and hepatocellular carcinoma maintained prominence throughout all periods, with the recent emergence of the COVID-19 theme in 2021–2024

Fig. 4

Thematic evolution of HCV genotyping-related research in the Eastern Mediterranean Region

Fig. 5

Trend topics of Hepatitis C research in the Eastern Mediterranean Region in Scopus from 2004 to 2024, showing evolution from early focus on genotype 4, interferon, and ribavirin treatments to advanced approaches with direct-acting antivirals and molecular docking, and recent integration of public health concerns like COVID-19

Fig. 6

Country collaboration network analysis revealing a central, highly collaborative cluster (red nodes) and distinct Eastern Mediterranean country clusters. Iran (purple) and Pakistan (green) show limited external collaboration, while Egypt (brown) demonstrates stronger ties to other nodes, indicating a bridging role within the network

Fig. 7

Flowchart of the overall key findings