Handbook of Disease Burdens and Quality of Life Measures pp 1323-1334 | Cite as
DALYs in Chronic Hepatitis C : A Paneuropean Perspective
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.
KeywordsLiver Cancer European Region Attributable Fraction Life Impairment Disability Component
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
WHO Global Burden of Disease Project (GBD)
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
Short Form 36 (health survey questionnaire), a generic quality-of-life profile instrument
World Health Organization
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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