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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

Abstract:

 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.

Keywords

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:

AF

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

ALT

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

DALY

 Disability adjusted life years

GBD

WHO Global Burden of Disease Project (GBD)

HBV

 Hepatitis B virus

HCV

Hepatitis C virus

ICD-10

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

RNA

Ribonucleic acid

SF-36

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

WHO

World Health Organization

YLD

 Life years lost to disability

YLL

Years of life lost from premature death

Notes

Acknowledgments

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.

References

  1. Anonymous. (1997). Hepatology. 26: 2S–10S.Google Scholar
  2. European Association on the Studies on the Liver (EASL). (1999). J Hepatol. 31(Suppl 1): 3–8.Google Scholar
  3. European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Jager J, Limburg W, Kretzschmar M, Postma M, Wiessing L. Hepatitis C and injecting drug use: impact, costs and policy options. Monograph 7 [monograph on the Internet]. Lisbon: European Monitoring Centre for Drugs and Drug Addiction; 2004 [cited 2007 Sept]. Available from: http://www.emcdda.eu.int/?nnodeid=428.
  4. Foster GR, Goldin RD, Thomas HC. (1998). Hepatology. 27: 209–212.PubMedCrossRefGoogle Scholar
  5. Gjeruldsen S, Loge JH, Myrvang B, Opjordsmoen S. (2006). Nord J Psychiatry. 60: 157–161.PubMedCrossRefGoogle Scholar
  6. Hollander A, Foster GR, Weiland O. (2006). Scand J Gastroenterol. 41: 577–585.PubMedCrossRefGoogle Scholar
  7. Lang CA, Conrad S, Garrett L, Battistutta D, Cooksley WG, Dunne MP, Macdonald GA. (2006). J Pain Symptom Manage. 31: 335–344.PubMedCrossRefGoogle Scholar
  8. Lauer GM, Walker BD. (2001). N Engl J Med. 345: 41–52.PubMedCrossRefGoogle Scholar
  9. Lettmeier B, Mühlberger N, Schwarzer R, Sroczynski G, Wright D, Zeuzem S, Siebert U. (2008). J Hepatol. 49: 528–536.PubMedCrossRefGoogle Scholar
  10. Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJL (2006). Global Burden of Disease and Risk Factors. Oxford University Press, New York. Also available from: http://www.dcp2.org/pubs/GBD.
  11. Mathers CD, Bernard C, Moesgaard Iburg K, Inoue M, Ma Fat D, Shibuya K, Stein C, Tomijima N, Xu H. Global Burden of Disease in 2002: data sources, methods and results. Global Programme on Evidence for Health Policy Discussion Paper No. 54 [monograph on the Internet]. World Health Organization, Geneva, Switzerland 2003, revised 2004 [cited: 2006 Oct]. Available from: http://www.who.int/healthinfo/paper54.pdf.
  12. Mathers CD. Uncertainty and data availability for the global burden of disease estimates 2000–2002 [monograph on the Internet]. 2005 [cited 2007 Mar]. Available from: http://www.who.int/healthinfo/publications/boduncertaintypaper2002.pdf.
  13. Murray CJ. (1994). Bull World Health Organ. 72: 429–445.PubMedGoogle Scholar
  14. Murray CJ, Lopez AD. (1994). Bull World Health Organ 72: 481–494.PubMedGoogle Scholar
  15. Murray CJ, Lopez AD. (1997). Bull World Health Organ 75: 377–381.PubMedGoogle Scholar
  16. National Institute of Health (NIH). (2002). Hepatology. 36: S3–S20.Google Scholar
  17. Parkin DM. (2006). Int J Cancer. 118: 3030–3044.PubMedCrossRefGoogle Scholar
  18. Perz JF, Armstrong GL, Farrington LA, Hutin YJ, Bell BP. (2006). J Hepatol. 45: 529–538.PubMedCrossRefGoogle Scholar
  19. Peters MG, Terrault NA. (2002). Hepatology. 36: S220–S225.PubMedCrossRefGoogle Scholar
  20. Sassi F. (2006). Health Policy Plan. 21: 402–408.PubMedCrossRefGoogle Scholar
  21. Shepard CW, Finelli L, Alter MJ. (2005). Lancet Infect Dis. 5: 558–567.PubMedCrossRefGoogle Scholar
  22. Siebert U, Sroczynski G, on behalf of the German Hepatitis C Model (GEHMO) Group and the HTA Expert Panel on Hepatitis C. (2003). [Antiviral therapy for patients with chronic hepatitis C in Germany. Evaluation of effectiveness and cost-effectiveness of initial combination therapy with Interferon/Peginterferon plus Ribavirin. Series of the German Institute for Medical Documentation and Information commissioned by the Federal Ministry of Health and Social Security]. Vol. 8. DIMDI, Köln.Google Scholar
  23. Siebert U, Sroczynski G, on behalf of the German Hepatitis C Model (GEHMO) Group and the HTA Expert Panel on Hepatitis C. (2005). Int J Technol Assess Health Care. 21: 55–65.PubMedCrossRefGoogle Scholar
  24. Spiegel BM, Younossi ZM, Hays RD, Revicki D, Robbins S, Kanwal F. (2005). Hepatology. 41: 790–800.PubMedCrossRefGoogle Scholar
  25. The Global Burden of Disease Working Group. (2004). J Clin Pharmacol. 44: 20–29.Google Scholar
  26. von Wagner M, Lee JH, Kronenberger B, Friedl R, Sarrazin C, Teuber G, Herrmann E, Zeuzem S. (2006). J Viral Hepat. 13: 828–834.PubMedCrossRefGoogle Scholar
  27. World Health Organization. The Global Burden of Disease project: results for 2002 and earlier years, methods, documentation and publications. Manuals, resources and software for carrying out national burden of disease studies [website on the Internet]. [cited 2007 Mar]. Available from: http://www.who.int/healthinfo/bodproject/en/index.html.
  28. World Health Organization. Hepatitis C [monograph on the Internet]. 1999a [cited 2006 Oct]. Available from: http://www.who.int/immunization/topics/hepatitis_c/en/index.html/.
  29. World Health Organization. (1999b). J Viral Hepat. 6: 35–47.Google Scholar
  30. World Health Organization. Mortality and burden of disease estimates for WHO member states in 2002 [database on the Internet]. 2004a [updated N.N.; cited 2006 Oct]. Available from: http://www3.who.int/whosis/burden/estimates/2002Rev/2002RevCountries/DthDALY2002.zip.
  31. World Health Organization. Estimates of Years Lost due to Disability by sex, cause and WHO Region for 2002 [monograph on the Internet]. 2004b [cited 2007 Mar]. Available from: http://www.who.int/entity/healthinfo/statistics/gbdwhoregionyld2002.xls.
  32. World Health Organization. Estimates of DALYs by sex, cause and WHO Region for 2002 [monograph on the Internet]. 2004c [cited Mar 2007]. Available from: http://www.who.int/healthinfo/statistics/gbdwhoregiondaly2002.xls.

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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