Burden of disease related to hepatitis C and hepatitis B in Spain: a methodological challenge of an unfolding health problem

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http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2893.2011.01467.x/abstract

Burden of disease related to hepatitis C and hepatitis B in Spain: a

methodological challenge of an unfolding health problem

A. García-Fulgueiras1,2, R. García-Pina1,2, C. Morant3, N. Fernández de

Larrea-Baz3, E. Ãlvarez4

Article first published online: 1 JUN 2011

DOI: 10.1111/j.1365-2893.2011.01467.x

© 2011 Blackwell Publishing Ltd

Issue

Journal of Viral Hepatitis

Volume 18, Issue 10, pages e453–e460, October 2011

ABSTRACT

Summary.  Most previous studies of burden of disease (BoD) in the area of

transmissible diseases have assessed the burden of hepatitis C and B without

including the end stages of the disease and using an incident approach. We aimed

to assess the disability-adjusted life years (DALYs) related to hepatitis C and

B in Spain in 2006 taking into account related cirrhosis and liver cancer. A

prevalence approach was used to estimate current years lived with disability

(YLD) because of viral hepatitis contracted years/decades before. We added years

of life lost (YLL) to obtain DALYs. Around 76 000 DALYs were attributed to

hepatitis C virus (HCV) and 15 323 to hepatitis B virus (HBV) when calculated

without applying social values. Applying the discount rate and age-weighting

used in the Global Burden Disease study, the BoD nearly halved. In any case, the

burden related to hepatitis C including long-term outputs becomes the leading

cause of DALYs among transmissible diseases in Spain. The mortality component

(YLL) represents more than 90% of the BoD in both HCV and HBV. The findings

emphasize the need to provide good surveillance systems not only concerning

acute viral hepatitis, but also chronic and end-stage consequences to allow a

reliable assessment of the prevention and public health control policies.