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[荷兰慢性乙型和丙型病毒感染导致的死亡率]

[Mortality due to chronic viral hepatitis B and C infections in the Netherlands].

作者信息

Hofman R, Nusselder W J, Veldhuijzen I K, Richardus J H

机构信息

Erasmus MC, afd. Maatschappelijke Gezondheidszorg, Rotterdam.

出版信息

Ned Tijdschr Geneeskd. 2016;160:D511.

Abstract

OBJECTIVE

To estimate mortality due to chronic hepatitis B-virus (HBV) and hepatitis C-virus (HCV) infections in the Netherlands from 2002 to 2015.

DESIGN

A cross-sectional analysis based on cause-of-death statistics.

METHOD

From Statistics Netherlands we obtained detailed data regarding the number of deaths per year in the following ICD-10 categories: chronic viral hepatitis; malignant neoplasm of the liver and intrahepatic bile ducts; fibrosis and cirrhosis of the liver; and alcoholic liver disease. We determined the population-attributable fractions (PAF) of HBV and HCV infections in mortality due to hepatocellular carcinoma (HCC) and cirrhosis of the liver, and added these to the recorded mortality from viral hepatitis in order to calculate total mortality. We used Dutch research as a basis for allocation to HCC, and a range of PAFs from 3 studies for cirrhosis. Poisson regression was used to assess mortality trends over time and any differences in demographic characteristics.

RESULTS

Around 500 Dutch people died annually of chronic viral hepatitis from 2002 to 2015, according to our 'middle' estimate; the 'lowest' estimate yields 340 and the 'highest' 600 people per year. The total mortality due to a chronic HBV and HCV infection did not change over time. The mortality for HCC due to viral hepatitis increased slightly over time and the mortality for cirrhosis decreased slightly. HCC mortality due to viral hepatitis was higher in Dutch people of non-western origin.

CONCLUSION

Mortality from chronic viral hepatitis is mostly the result of cirrhosis of the liver and HCC. About 500 persons died annually from 2002 to 2015 from causes linked to viral hepatitis.

摘要

目的

估算2002年至2015年荷兰慢性乙型肝炎病毒(HBV)和丙型肝炎病毒(HCV)感染导致的死亡率。

设计

基于死因统计的横断面分析。

方法

我们从荷兰统计局获取了以下国际疾病分类第十版(ICD - 10)类别中每年死亡人数的详细数据:慢性病毒性肝炎;肝和肝内胆管恶性肿瘤;肝纤维化和肝硬化;以及酒精性肝病。我们确定了HBV和HCV感染在肝细胞癌(HCC)和肝硬化导致的死亡率中的人群归因分数(PAF),并将这些分数加到记录的病毒性肝炎死亡率上,以计算总死亡率。我们以荷兰的研究为基础将病例分配至HCC,并采用了3项研究中关于肝硬化的一系列PAF值。使用泊松回归评估死亡率随时间的趋势以及人口统计学特征的任何差异。

结果

根据我们的“中等”估计,2002年至2015年每年约有500名荷兰人死于慢性病毒性肝炎;“最低”估计为每年340人,“最高”估计为每年600人。慢性HBV和HCV感染导致的总死亡率随时间未发生变化。病毒性肝炎导致的HCC死亡率随时间略有上升,肝硬化死亡率略有下降。非西方裔荷兰人中病毒性肝炎导致的HCC死亡率更高。

结论

慢性病毒性肝炎导致的死亡主要是肝硬变和HCC的结果。2002年至2015年每年约有500人死于与病毒性肝炎相关的病因。

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