The global burden of viral hepatitis from 1990 to 2013: findings from the Global Burden of Disease Study 2013.
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Stanaway Jeffrey D, Flaxman Abraham D, Naghavi Mohsen, Fitzmaurice Christina, Vos Theo, Abubakar Ibrahim, Abu-Raddad Laith J, Assadi Reza, Bhala Neeraj, Cowie Benjamin, Forouzanfour Mohammad H, Groeger Justina, Hanafiah Khayriyyah Mohd, Jacobsen Kathryn H, James Spencer L, MacLachlan Jennifer, Malekzadeh Reza, Martin Natasha K, Mokdad Ali A, Mokdad Ali H, Murray Christopher J L, Plass Dietrich, Rana Saleem, Rein David B, Richardus Jan Hendrik, Sanabria Juan, Saylan Mete, Shahraz Saeid, So Samuel, Vlassov Vasiliy V, Weiderpass Elisabete, Wiersma Steven T, Younis Mustafa, Yu Chuanhua, El Sayed Zaki Maysaa, Cooke Graham S
Аннотация
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.