Epidemiology of Acute Hepatitis C and HCV-related Cirrhosis in Reproductive-Age Women, 1990-2019: A Global Burden of Disease Study

Abstract Background & Aims: Considering the risk of vertical transmission and the adverse perinatal outcomes associated with hepatitis C virus (HCV) infection, women of reproductive age warrant prioritization in HCV prevention efforts. This study aims to examine the global incidence and temporal trends of acute hepatitis C (AHC) and HCV-related cirrhosis among women of reproductive age (15-49 years) from 1990 to 2019. Methods:Leveraging the Global Burden of Disease 2019 data, we calculated age-standardized incidence rates (ASIR) and assessed temporal trends via the average annual percent change (AAPC) from joinpoint regression. The age-period-cohort (APC) model was employed for a further understanding of the age, period, and birth cohort effects. Results: Over the 30-year period, global incidences of AHC and HCV-related cirrhosis in reproductive-age women increased by 46.45% and 72.74%, respectively. The ASIR of AHC was highest in low socio-demographic index (SDI) regions but showed a declining trend. Conversely, the ASIR of HCV-related cirrhosis displayed unfavorable trends in low, low-middle, and high SDI regions. Special attention is necessary for Sub-Saharan Africa, High-income North America, Eastern Europe, and Central Asia due to their high incidence rates or increasing trends of AHC and HCV-related cirrhosis. Notably, the APC model suggests a recent resurgence in both AHC and HCV-related cirrhosis risk. Conclusions: Despite advancements in HCV treatment, HCV infection remains a health burden in reproductive-age women. This study provides an in-depth understanding of the epidemiology of AHC and HCV-related cirrhosis in this demographic, facilitating the development of targeted prevention and treatment strategies.