Global burden of hepatitis C virus infection related to high body mass index and future forecast: an analysis based on the global burden of disease study 2021.

Objective: The global prevalence of obesity is rising, and prior research has established a strong link between obesity and hepatitis C prognosis. However, the impact of high body mass index (HBMI) on the HCV burden remains uncertain. This study sought to clarify the overall HCV burden related to HBMI and examine temporal trends. Methods: Public data from the Global Burden of Disease (GBD) database (1990-2021) were utilized to analyze the global and different Socio-demographic index (SDI) regional burden of HCV associated with obesity, focusing on Deaths, Disability-Adjusted Life Years (DALYs), Years Lived with Disability (YLDs), and Years of Life Lost (YLLs). Trends in the HCV burden were assessed using Estimated Annual Percentage Changes (EAPCs) and Average Annual Percentage Changes (AAPCs) via Joinpoint regression. The age-period-cohort (APC) model was used to examine the effects of age, period, and cohort on disease burden, respectively. The Das Gupta decomposition analysis method was applied to evaluate the contributions of population growth, population aging, and epidemiological changes to the burden. Frontier analysis was conducted to explore the relationship between the HCV burden linked to HBMI and Socio-demographic development. An ARIMA model was then developed to forecast the Age-standardized Mortality Rate (ASMR) and Age-standardized DALYs Rate (ASDR) of HBMI-associated hepatitis C over the next 15 years. Results: From 1990 to 2021, global HCV deaths related to obesity rose from 3,835 to 17,090, with DALYs increasing from 94,503 to 389,263. The EAPCs for ASMR and ASDR were 2.20 and 2.10, respectively. Obesity posed a greater burden on female patients infected with HCV virus compared to males. In terms of age, the effect of HBMI on HCV patients increased with age. Over the past 30 years, ASMR and ASDR have consistently risen across all SDI regions (All regions: EAPCs > 0, 95% CIs > 0). The High SDI region reported the highest deaths, DALYs, ASMR, and ASDR annually, indicating the greatest obesity impact on HCV burden of this area. However, obesity also had an increasingly large impact on the HCV disease burden in the Middle SDI and Low-middle SDI regions. Regionally, Africa, the Middle East, and Central Asia bear a relatively heavy burden of HCV associated with HBMI, and the burden in North America and Oceania cannot be ignored. At the national level, Mongolia and Egypt have the heaviest burden. The results of decomposition analysis show that epidemiological changes are the main cause of the increased burden. Projections suggest a continued increase in the obesity-related HCV burden globally and across different SDI regions over the next 15 years. Conclusion: Obesity poses an increasing disease burden for people infected with hepatitis C virus. Targeted public health interventions are urgently needed to alleviate this burden.