Websites offering pirated digital content and counterfeit goods generate more than 53 billion visits per year, according to a study released by MarkMonitor.

The top three -, and - generated more than 21 billion visits.

MarkMonitor, which provides brand protection services, said the amount of traffic generated by these sites as well as the range of locations used to host and register them indicates the complexity in finding a solution to the global problem of online piracy and counterfeiting.

Global piracy affects a wide range of digital content, including movies, music, games, software, television shows and e-books while the trade in counterfeit goods online touches almost every item, including apparel, footwear and electronics. MarkMonitor estimates the worldwide economic impact of online piracy and counterfeiting at $200 billion annually.

The study found that 67 percent of sites suspected of hosting pirated content and 73 percent of sites categorized as counterfeit were hosted in North America or Western Europe.

In previous 'test buys' of prescription pharmaceutical products from some of these sites, MarkMonitor found that payment processing and order fulfillment took place in countries other than that used to host the site or register its domain name, indicating that many of these sites conduct business across multiple national boundaries.

Online intellectual property theft-whether it is the sale of counterfeit shoes and fake drugs or the illegal distribution of movies, music, and software-steals jobs, threatens consumers, and hinders our economic growth, said Steve Tepp, senior director of internet counterfeiting and piracy for the Global Intellectual Property Center at the U.S. Chamber of Commerce.

MarkMonitor conducted the study during 2010 using a sample of 22 brands from product categories including prescription drugs, luxury goods, music, films and athletic gear.

Because of the small sample of brands used in the study, it provides a snapshot of the scope of online theft of intellectual property and illicit e-commerce. Given the large number of popular brands, it is reasonable to assume that hundreds of thousands of other rights-holders, brands and content creators are suffering the same damage.