Viral hepatitis-related mortality increased by 63% over a 23-year period, whereas mortality from other infectious diseases, such as HIV, tuberculosis and malaria have decreased, according to newly published data in The Lancet.
“Viral hepatitis … is now the 7th leading cause of death in the world. It is relatively neglected in terms of resource to tackling it,” Graham S. Cooke, PhD, of the department of medicine at Imperial College London, told Healio.com/Hepatology. “Hepatitis C is a key driver to the increases [in viral hepatitis deaths]. We have a number of excellent new treatments for hepatitis C, but in both rich and poor countries, we need to do more to make them affordable and accessible.”
Graham S. Cooke
Cooke and colleagues evaluated data from the Global Burden of Disease Study to measure morbidity and mortality from acute viral hepatitis (hepatitis A, B, C and E) and for cirrhosis and hepatocellular carcinoma deaths secondary to HBV and HCV. The data were divided and assessed based on age group, sex and country between 1990 and 2013.
Results showed between 1990 and 2013, global deaths from viral hepatitis increased from 0.89 million (95% uncertainty interval [UI], 0.86-0.94) to 1.45 million (95% UI, 1.38-1.54). The years of life lost increased from 31 million (95% UI, 29.6-32.6) to 41.6 million (95% UI, 39.1-44.7).
The years lived with disability increased from 0.65 million (95% UI, 0.45-0.89) to 0.87 million (95% CI, 0.61-1.18) and disability-adjusted life-years (DALYs) increased from 31.7 million (95% UI, 30.2-33.3) to 42.5 million (95% UI, 39.9-45.6).
“This is the most comprehensive analysis to date of the global burden of viral hepatitis, and it reveals startling findings — showing the death toll from this condition is now 1.45 million, whereas deaths from many other infectious diseases — such as TB and malaria — have dropped since 1990, viral hepatitis deaths have risen,” Cooke said.
Together, viral hepatitis mortality from acute infection, cirrhosis and HCC became the seventh leading cause of mortality worldwide by 2013 compared with 10th in 1990. On the contrary, malaria, TB and diarrheal disease decreased over the same period.
HBV and HCV accounted for 96% of deaths related to viral hepatitis (95% UI, 94-97) and 91% of DALYs related to viral hepatitis (95% UI, 88-93) in 2013. The researchers noted that these numbers did not significantly change from 1990.
Most hepatitis-related deaths occurred in East Asia and were due to HBV and HCV.
The researchers concluded: “Our results suggest that an evolution in funding structures is required to accommodate the burden of viral hepatitis and allow effective responses in low-income and lower–middle-income countries.” – by Melinda Stevens
Disclosure: Cooke reports being an investigator on trials of HCV treatment sponsored by Boehringer-Ingelheim, Gilead Sciences, Merck and Bristol-Myers Squibb. He also reports advising for Merck, Boehringer-Ingelheim, Gilead, Janssen and the WHO. Please see the full study for a list of all other researchers’ relevant financial disclosures.