Fulltext

The global burden of viral hepatitis from 1990 to 2013: findings from the Global Burden of Disease Study 2013

Stanaway JD 1 , Flaxman AD 2 , Naghavi M 2 , Fitzmaurice C 3 , Vos T 2 , Abubakar I 4 Show all authors , Abu-Raddad LJ 5 , Assadi R 6 , Bhala N 7 , Cowie B 8 , Forouzanfour MH 2 , Groeger J 9 , Hanafiah KM 10 , Jacobsen KH 11 , James SL 12 , MacLachlan J 8 , Malekzadeh R 13 , Martin NK 14 , Mokdad AA 15 , Mokdad AH 2 , Murray CJL 2 , Plass D 16 , Rana S 17 , Rein DB 18 , Richardus JH 19 , Sanabria J 20 , Saylan M 21 , Shahraz S 22 , So S 23 , Vlassov VV 24 , Weiderpass E 25 , Wiersma ST 26 , Younis M 27 , Yu C 28 , El Sayed Zaki M 29 , Cooke GS 30

Affiliations 

  • 1 Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA. Electronic address: stanaway@uw.edu
  • 2 Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
  • 3 Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Division of Hematology, Department of Medicine, University of Washington, Seattle, WA, USA
  • 4 Institute for Global Health, University College London, London, UK
  • 5 Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Qatar Foundation, Doha, Qatar
  • 6 Mashhad University of Medical Sciences, Mashhad, Iran
  • 7 Queen Elizabeth Hospital Birmingham, Birmingham, UK; University of Otago Medical School, Wellington, New Zealand
  • 8 WHO Collaborating Centre for Viral Hepatitis, Victorian Infectious Diseases Reference Laboratory, Melbourne, VIC, Australia; Doherty Institute, University of Melbourne, Melbourne, VIC, Australia
  • 9 Johns Hopkins Bayview Medical Center, Baltimore, MD, USA
  • 10 Centre for Biomedical Research, Burnet Institute, Melbourne, VIC, Australia; School of Biological Sciences, Universiti Sains Malaysia, Penang, Malaysia
  • 11 Department of Global and Community Health, George Mason University, Fairfax, VA, USA
  • 12 Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, NH, USA
  • 13 Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  • 14 Division of Global Public Health, University of California San Diego, San Diego, CA, USA; School of Social and Community Medicine, University of Bristol, Bristol, UK
  • 15 Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
  • 16 Section Exposure Assessment and Environmental Health Indicators, Federal Environmental Agency, Berlin, Germany
  • 17 Contech School of Public Health, Lahore, Pakistan; Contech International Health Consultants, Lahore, Pakistan
  • 18 NORC at the University of Chicago, Chicago, IL, USA
  • 19 Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
  • 20 Case Western Reserve University, Cleveland, OH, USA; Cancer Treatment Centers of America, Rosalind Franklin University Chicago Medical School, North Chicago, IL, USA
  • 21 Bayer AG Turkey, Fatih Sultan Mehmet Mah Balkan Cad, Istanbul, Turkey
  • 22 Tufts Medical Center, Boston, MA, USA
  • 23 Asian Liver Center, Stanford University School of Medicine, Palo Alto, CA, USA
  • 24 National Research University Higher School of Economics, Moscow, Russia
  • 25 Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden; Department of Research, Cancer Registry of Norway, Oslo, Norway; Department of Community Medicine, Faculty of Health Sciences, University of Tromsø-The Arctic University of Norway, Tromsø, Norway; Genetic Epidemiology Group, Folkhälsan Research Center, University of Helsinki, Helsinki, Finland
  • 26 US Centers for Disease Control and Prevention, Kampala, Uganda
  • 27 Jackson State University, Jackson, MS, USA
  • 28 Department of Epidemiology and Biostatistics, School of Public Health, and Global Health Institute, Wuhan University, Wuhan, Hubei, China
  • 29 Faculty of Medicine, Mansoura University, Mansoura, Egypt
  • 30 Division of Infectious Diseases, Imperial College, London, UK. Electronic address: g.cooke@imperial.ac.uk
Lancet, 2016 Sep 10;388(10049):1081-1088.
PMID: 27394647 DOI: 10.1016/S0140-6736(16)30579-7

Abstract

BACKGROUND: With recent improvements in vaccines and treatments against viral hepatitis, an improved understanding of the burden of viral hepatitis is needed to inform global intervention strategies. We used data from the Global Burden of Disease (GBD) Study to estimate morbidity and mortality for acute viral hepatitis, and for cirrhosis and liver cancer caused by viral hepatitis, by age, sex, and country from 1990 to 2013.

METHODS: We estimated mortality using natural history models for acute hepatitis infections and GBD's cause-of-death ensemble model for cirrhosis and liver cancer. We used meta-regression to estimate total cirrhosis and total liver cancer prevalence, as well as the proportion of cirrhosis and liver cancer attributable to each cause. We then estimated cause-specific prevalence as the product of the total prevalence and the proportion attributable to a specific cause. Disability-adjusted life-years (DALYs) were calculated as the sum of years of life lost (YLLs) and years lived with disability (YLDs).

FINDINGS: Between 1990 and 2013, global viral hepatitis deaths increased from 0·89 million (95% uncertainty interval [UI] 0·86-0·94) to 1·45 million (1·38-1·54); YLLs from 31·0 million (29·6-32·6) to 41·6 million (39·1-44·7); YLDs from 0·65 million (0·45-0·89) to 0·87 million (0·61-1·18); and DALYs from 31·7 million (30·2-33·3) to 42·5 million (39·9-45·6). In 2013, viral hepatitis was the seventh (95% UI seventh to eighth) leading cause of death worldwide, compared with tenth (tenth to 12th) in 1990.

INTERPRETATION: Viral hepatitis is a leading cause of death and disability worldwide. Unlike most communicable diseases, the absolute burden and relative rank of viral hepatitis increased between 1990 and 2013. The enormous health loss attributable to viral hepatitis, and the availability of effective vaccines and treatments, suggests an important opportunity to improve public health.

FUNDING: Bill & Melinda Gates Foundation.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

MeSH terms
Similar publications