Perazzo Hugo, Pacheco Antonio G, Luz Paula M, Castro Rodolfo, Hyde Chris, Fittipaldi Juliana, Rigolon Caroline, Cardoso Sandra W, Grinsztejn Beatriz, Veloso Valdiléa G
Fundação Oswaldo Cruz (FIOCRUZ), Instituto Nacional de Infectologia Evandro Chagas (INI), Laboratório de Pesquisa Clínica em DST e AIDS (LAPCLIN-AIDS), Rio de Janeiro, Brazil.
Fundação Oswaldo Cruz (FIOCRUZ), Programa de Computação Científica (PROCC), Rio de Janeiro, Brazil.
BMC Infect Dis. 2017 Jul 31;17(1):527. doi: 10.1186/s12879-017-2619-y.
Liver-related mortality has been increasing worldwide. We aimed to estimate the age-standardized mortality rates from viral hepatitis in Brazil.
The Brazilian National Death Registry was analyzed from 2008 to 2014. Viral hepatitis deaths were defined by the following ICD-10 codes in the death certificate: hepatitis A [B15.0; B15.9]; hepatitis B [B16.2; B16.9; B18.1]; hepatitis C [B17.1; B18.2]; hepatitis Delta [B16.0; B16.1; B18.0; B17.0] and other viral hepatitis [B17.2; B17.8; B18.8; B18.9; B19.0; B19.9]. Crude mortality rates were calculated by the ratio between total number of deaths and estimated population. Mortality rates were age-standardized by the direct method using the WHO standard population.
Thirty four thousand ,nine hundred seventy eight deaths had viral hepatitis mentioned in their death certificate [65% male, aged 58 years, 73% associated with hepatitis C]. Age-standardized mortality rate (95% CI) due to viral hepatitis was 2.695 (2.667-2.724) deaths per 100,000 inhabitants: South region had the higher rates [3.997 (3.911-4.085)]. Mortality rates associated with hepatitis A and Delta were 0.032 (0.029-0.035) and 0.028 (0.025-0.031), respectively. Hepatitis C mortality rates were 4-fold higher than those associated with hepatitis B [1.964 (1.940-1.989) vs 0.500 (0.488-0.512)]. South region had the higher rates for hepatitis C [3.163 (3.087-3.241)] and North had the higher rates for hepatitis A [0.066 (0.049-0.087)], B [0.986 (0.918-1.058)] and Delta [0.220 (0.190-0.253)].
Viral hepatitis remains a major public health issue in Brazil. Mortality rates were not homogeneous across the country, suggesting that health policies should be customized according to geographical location.
全球范围内，肝脏相关死亡率一直在上升。我们旨在估算巴西病毒性肝炎的年龄标准化死亡率。
对2008年至2014年巴西国家死亡登记处的数据进行分析。病毒性肝炎死亡由死亡证明中的以下国际疾病分类第十版（ICD - 10）编码定义：甲型肝炎[B15.0；B15.9]；乙型肝炎[B16.2；B16.9；B18.1]；丙型肝炎[B17.1；B18.2]；丁型肝炎[B16.0；B16.1；B18.0；B17.0]以及其他病毒性肝炎[B17.2；B17.8；B18.8；B18.9；B19.0；B19.9]。粗死亡率通过死亡总数与估计人口数的比率计算得出。死亡率采用直接法，以世界卫生组织标准人口进行年龄标准化。
在其死亡证明中提及病毒性肝炎的死亡人数为34978例[男性占65%，年龄58岁，73%与丙型肝炎相关]。病毒性肝炎的年龄标准化死亡率（95%置信区间）为每10万居民2.695（2.667 - 2.724）例死亡：南部地区的死亡率较高[3.997（3.911 - 4.085）]。与甲型肝炎和丁型肝炎相关的死亡率分别为0.032（0.029 - 0.035）和0.028（0.025 - 0.031）。丙型肝炎的死亡率比乙型肝炎高4倍[1.964（1.940 - 1.989）对0.500（0.488 - 0.512）]。南部地区丙型肝炎的死亡率较高[3.163（3.087 - 3.241）]，北部地区甲型肝炎[0.066（0.049 - 0.087）]、乙型肝炎[0.986（0.918 - 1.058）]和丁型肝炎[0.220（0.190 - 0.253）]的死亡率较高。
病毒性肝炎在巴西仍然是一个主要的公共卫生问题。全国死亡率并不均匀，这表明卫生政策应根据地理位置进行定制。
