Synergistic impact of high body-mass index on HBV/HCV-related liver cancer burden globally: Analysis and projections 1990–2050

Objectives: To quantify and forecast the global, regional, and national disease burden of hepatitis B virus (HBV) and hepatitis C virus (HCV)-related liver cancer attributable to high body-mass index (BMI) from 1990 to 2050. Study Design: A global burden and projection study utilizing GBD 2021 data analysis. Methods: Data from the Global Burden of Disease (GBD) Study 2021 were analyzed to estimate deaths, disability-adjusted life years (DALYs), and age-standardized rates (ASRs) associated with HBV/HCV-related liver cancer attributable to high BMI globally and across regions. Temporal trends from 1990 to 2021 were assessed using estimated annual percentage change (EAPC) and hierarchical cluster analysis. Forecasts for disease burden to 2050 employed Autoregressive Integrated Moving Average (ARIMA) and exponential smoothing (ES) models. Results: In 2021, globally, high BMI contributed to approximately 15,698 HBV-related deaths and 17,090 HCV-related deaths, a marked increase since 1990. Burdens were higher among males, older populations, and exhibited substantial regional variations, with the greatest burden observed in China and increasing trends notable in Central Asia, Australasia, and North America. Forecasting models project a continued rise in liver cancer burden attributable to high BMI through 2050. Conclusions: The disease burden of HBV/HCV-related liver cancer attributable to high BMI has significantly increased globally and is projected to further rise. Public health initiatives integrating viral hepatitis control with obesity prevention are urgently needed to mitigate future disease burdens.