DALYs in Chronic Hepatitis C : A Paneuropean Perspective

  • U. Siebert
  • A. Conrads-Frank
  • R. Schwarzer
  • B. Lettmeier
  • G. Sroczynski
  • S. Zeuzem
  • N. Mühlberger
Reference work entry


 Hepatitis C virus (HCV) is one of the leading causes of chronic liver disease with serious sequelae such as end-stage cirrhosis and liver cancer. However, few burden of disease data that consider health-related quality of life are available for Europe.

The objective of this evaluation was to summarize available data on the HCV-related burden of disease under consideration of the reduction in quality of life for countries of the WHO European region.

We analyzed available data on disability-adjusted life years ( DALY) and life years lost to disability ( YLD). Literature and international health databases were systematically searched for HCV-related data on DALY and YLD. If no HCV-specific data were available, these were calculated via HCV-attributable fractions.

HCV-specific DALY data were only available for hepatitis C without cirrhosis and liver cancer and for all cause cirrhosis and liver cancer. The calculation via HCV-attributable fractions yielded that approximately 1.2 million DALYs were lost due to HCV in 2002 in the WHO European region, of which about one sixth can be attributed to quality-of-life impairment. About 95% of the DALYs were accumulated by patients in advanced disease stages.

Our results emphasize the public health relevance of hepatitis C and highlight the importance and the potential benefit of preventive antiviral treatment. The variation of DALY figures indicate the potential of inequality of health services across the countries of the WHO European region that should be investigated further. The finding that HCV-specific data are not available suggests that the crisis is not yet fully perceived on the European level.


Liver Cancer European Region Attributable Fraction Life Impairment Disability Component 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

List of Abbreviations:


Attributable fractions, in this chapter used for the fraction of cases of liver cirrhosis and liver cancer, that are caused by HCV infection


Serum alanine aminotransferase. A liver enzyme that is an indicator of liver disease


 Disability adjusted life years


WHO Global Burden of Disease Project (GBD)


 Hepatitis B virus


Hepatitis C virus


The International Statistical Classification of Diseases and Related Health Problems 10th

ICD-10 Code B20-B24

ICD-10 Code for human immunodeficiency virus (HIV) disease

ICD-10 Code C16

ICD-10 Code for malignant neoplasm of the stomach


Ribonucleic acid


Short Form 36 (health survey questionnaire), a generic quality-of-life profile instrument


World Health Organization


 Life years lost to disability


Years of life lost from premature death



This project was supported in part by an unrestricted research grant from Hoffmann La-Roche Ltd., Basel, Switzerland. The authors had complete and independent control over study design, analysis and interpretation of data, report writing, and publication, regardless of results.


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Copyright information

© Springer Science+Business Media LLC 2010

Authors and Affiliations

  • U. Siebert
    • 1
    • 2
  • A. Conrads-Frank
  • R. Schwarzer
  • B. Lettmeier
  • G. Sroczynski
  • S. Zeuzem
    • 3
  • N. Mühlberger
  1. 1.Institute for Technology Assessment and Department of Radiology, Massachusetts General HospitalHarvard Medical SchoolBostonUSA
  2. 2.Program in Health Decision Science Department of Health Policy and ManagementHarvard School of Public HealthBostonUSA
  3. 3.Department of Internal Medicine, Gastroenterology, Hepatology, Pneumology and EndocrinologyJohann Wolfgang Goethe-UniversityFrankfurt A.M.Germany

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