Central Michigan University College of Medicine, Saginaw, Michigan, USA.
Hepatitis B Foundation, Doylestown, Pennsylvania, USA.
Liver Int. 2022 Oct;42(10):2145-2153. doi: 10.1111/liv.15347. Epub 2022 Jul 4.
Advances in hepatitis B virus (HBV) and hepatitis C virus (HCV) therapies have improved morbidity and mortality, but global disparities in viral hepatitis outcomes remain. We evaluate global trends in the impact of HBV and HCV on disability-adjusted life years (DALYs).
Using data from the 2010-2019 Global Burden of Diseases Study (GBD), overall all-cause DALYs for patients with acute HBV or HCV, HBV- or HCV-related cirrhosis, and HBV- or HCV-related hepatocellular carcinoma (HCC) was calculated as the sum of years of life lost because of premature death and years lived with disability. DALYs were presented as age-standardized rates per 100 000 population stratified by age and sex.
From 2010 to 2019, the overall global impact of HBV on DALYs per 100 000 decreased from 27.6 to 20.9 for acute HBV and 168.6 to 129.8 for HBV-related cirrhosis but remained stable for HBV-related HCC. The impact of HCV on DALYs per 100 000 decreased from 5.23 to 3.3 for acute HCV, 159.2 to 146.2 for HCV-related cirrhosis, and 37.5 to 34.9 for HCV-related HCC. We observed significant differences in the impact of HBV and HCV on DALYs when stratified by world regions.
Decreases in HBV and HCV DALYs from 2010 to 2019 were observed. Disparities in DALY improvements across world regions suggest unequal access to viral hepatitis care and treatment. Achieving goals of viral hepatitis elimination will require enhanced prevention efforts and funding for high-burden regions and regions that have not had substantial reductions in DALYs because of HBV and HCV.
乙型肝炎病毒 (HBV) 和丙型肝炎病毒 (HCV) 治疗方面的进展改善了发病率和死亡率,但全球病毒性肝炎结局仍存在差异。我们评估了 HBV 和 HCV 对伤残调整生命年 (DALY) 的影响的全球趋势。
利用 2010-2019 年全球疾病负担研究 (GBD) 的数据,计算了急性 HBV 或 HCV、HBV 或 HCV 相关肝硬化和 HBV 或 HCV 相关肝细胞癌 (HCC) 患者的全因 DALY,其计算方法是将因过早死亡而损失的年数和因残疾而存活的年数相加。DALY 按年龄和性别分层,以每 10 万人 100,000 人口标准化率表示。
从 2010 年到 2019 年,全球 HBV 对每 100,000 人口 DALY 的总体影响从急性 HBV 的 27.6 降至 20.9,从 HBV 相关肝硬化的 168.6 降至 129.8,但 HBV 相关 HCC 保持稳定。HCV 对每 100,000 人口 DALY 的影响从急性 HCV 的 5.23 降至 3.3,从 HCV 相关肝硬化的 159.2 降至 146.2,从 HCV 相关 HCC 的 37.5 降至 34.9。我们观察到按世界区域分层时,HBV 和 HCV 对 DALY 的影响存在显著差异。
从 2010 年到 2019 年,HBV 和 HCV 的 DALY 呈下降趋势。世界各地区 DALY 改善的差异表明,获得病毒性肝炎护理和治疗的机会不平等。要实现消除病毒性肝炎的目标,就需要加强高负担地区和由于 HBV 和 HCV 而 DALY 没有大幅减少的地区的预防工作和资金投入。