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

Jeffrey D Stanaway; Abraham D Flaxman; Mohsen Naghavi; Christina Fitzmaurice; Theo Vos; Ibrahim Abubakar; Laith J Abu-Raddad; Reza Assadi; Neeraj Bhala; Benjamin Cowie; Mohammad H Forouzanfour; Justina Groeger; Khayriyyah Mohd Hanafiah; Kathryn H Jacobsen; Spencer L James; Jennifer MacLachlan; Reza Malekzadeh; Natasha K Martin; Ali A Mokdad; Ali H Mokdad; Christopher J L Murray; Dietrich Plass; Saleem Rana; David B Rein; Jan Hendrik Richardus; Juan Sanabria; Mete Saylan; Saeid Shahraz; Samuel So; Vasiliy V Vlassov; Elisabete Weiderpass; Steven T Wiersma; Mustafa Younis; Chuanhua Yu; Maysaa El Sayed Zaki; Graham S Cooke

doi:10.1016/S0140-6736(16)30579-7

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

Lancet. 2016 Sep 10;388(10049):1081-1088. doi: 10.1016/S0140-6736(16)30579-7. Epub 2016 Jul 7.

Authors

Jeffrey D Stanaway¹, Abraham D Flaxman², Mohsen Naghavi², Christina Fitzmaurice³, Theo Vos², Ibrahim Abubakar⁴, Laith J Abu-Raddad⁵, Reza Assadi⁶, Neeraj Bhala⁷, Benjamin Cowie⁸, Mohammad H Forouzanfour², Justina Groeger⁹, Khayriyyah Mohd Hanafiah¹⁰, Kathryn H Jacobsen¹¹, Spencer L James¹², Jennifer MacLachlan⁸, Reza Malekzadeh¹³, Natasha K Martin¹⁴, Ali A Mokdad¹⁵, Ali H Mokdad², Christopher J L Murray², Dietrich Plass¹⁶, Saleem Rana¹⁷, David B Rein¹⁸, Jan Hendrik Richardus¹⁹, Juan Sanabria²⁰, Mete Saylan²¹, Saeid Shahraz²², Samuel So²³, Vasiliy V Vlassov²⁴, Elisabete Weiderpass²⁵, Steven T Wiersma²⁶, Mustafa Younis²⁷, Chuanhua Yu²⁸, Maysaa El Sayed Zaki²⁹, Graham S Cooke³⁰

Affiliations

¹ Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA. Electronic address: [email protected].
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: [email protected].

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.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Comment

MeSH terms

Cost of Illness
Disabled Persons
Global Health
Hepatitis
Humans
Life Expectancy*
Morbidity
Quality-Adjusted Life Years*

Abstract

Publication types

MeSH terms

Grants and funding