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

Abstract

Summary 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.

Hepatitis C: evaluation of outcomes and georeferencing of cases in Santa Cruz do Sul, Brazil, between 2002 and 2015. A cross-sectional study

“…It has been estimated that this will lead to 19 million deaths between 2015 and 2030 (11.8 million due to HBV and 7.2 million due to HCV) around the world. 23 In the present study, 22 cases (11%) developed cirrhosis or hepatocellular cancer.…”

“…1 Between 1990 and 2013, the number of deaths worldwide due to viral hepatitis increased from 0.89 million to 1.45 million. 23 In the absence of treatment, 20-30% of hepatitis B virus (HBV) and HCV-infected individuals will develop hepatocellular carcinoma or cirrhosis. It has been estimated that this will lead to 19 million deaths between 2015 and 2030 (11.8 million due to HBV and 7.2 million due to HCV) around the world.…”

“…Oliveira et al carried out a geoprocessing analysis on HCV cases in São Paulo and found that HCV infection was associated with low socioeconomic level. 23 One hypothesis that corroborates the greater presence of HCV cases in regions with low socioeconomic status could be that such individuals lack knowledge about HCV infection routes, such as the sharing of razors, use of Hepatitis C: evaluation of outcomes and georeferencing of cases in Santa Cruz do Sul, Brazil, between 2002 and 2015. A cross-sectional study pliers, tattooing with non-sterile material, unprotected sexual intercourse and use of needles shared among drug users.…”

Knowledge of Viral Hepatitis among MSM in a Sub-Saharan African City: A Cross-Sectional Study in Calabar, Nigeria

“…The burden of disease owing to viral hepatitis has worsened, from being the tenth, to the seventh leading cause of death, between 1990 and 2013 [1]. This transition may have occurred owing to inaccessibility and/or lack of knowledge of the availability of regular screening, effective vaccines, and treatments, particularly among high-risk groups [2].…”

Viral hepatitis: beginning of the end?

“…However, viral hepatitis has perhaps not been given as much spotlight as a health priority as other major infectious diseases (such as HIV and tuberculosis), despite the high morbidity and mortality associated with the consequences of this chronic infection: progressive liver disease, including cirrhosis and liver cancer. 1 has confirmed that viral hepatitis is one of the leading causes of death and disability worldwide, with at least as many deaths attributed to this infectious disease as HIV, tuberculosis or malaria. In fact, viral hepatitis now ranks as the seventh leading cause of global mortality.…”