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Estimating the attributable fraction of cirrhosis and hepatocellular carcinoma due to hepatitis B and C
A goal of the WHO strategy on the elimination of hepatitis as a public threat is a 65% reduction in the attributable mortality. Deaths related to hepatitis B and C infections are mostly due to decompensated cirrhosis and hepatocellular carcinoma (HCC) but accurately measuring mortality is challengin...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9290525/ https://www.ncbi.nlm.nih.gov/pubmed/34003542 http://dx.doi.org/10.1111/jvh.13545 |
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author | Duffell, Erika Cortez‐Pinto, Helena Simonova, Marieta Dalgard, Olav Dahl, Elin Hoffmann de Martel, Catherine Mozalevskis, Antons Buti, Maria Pavlova, Slava Hadzhilova, Tnaiq Simões, Carolina Katzarov, Krum Mardh, Otilia |
author_facet | Duffell, Erika Cortez‐Pinto, Helena Simonova, Marieta Dalgard, Olav Dahl, Elin Hoffmann de Martel, Catherine Mozalevskis, Antons Buti, Maria Pavlova, Slava Hadzhilova, Tnaiq Simões, Carolina Katzarov, Krum Mardh, Otilia |
author_sort | Duffell, Erika |
collection | PubMed |
description | A goal of the WHO strategy on the elimination of hepatitis as a public threat is a 65% reduction in the attributable mortality. Deaths related to hepatitis B and C infections are mostly due to decompensated cirrhosis and hepatocellular carcinoma (HCC) but accurately measuring mortality is challenging as death certificates often do not capture the underlying disease. The aim of this collaborative study between European Centre for Disease Prevention and Control (ECDC) and the European Association for the Study of the Liver (EASL) was to assess a WHO‐developed protocol to support countries in implementing studies to collect data on the fraction of cirrhosis and hepatocellular carcinoma attributable to hepatitis B and C. Three sentinel sites (in Bulgaria, Norway and Portugal) collected data for patients first admitted or seen in their centres during 2016. Patients with cirrhosis or HCC were identified through patient files or healthcare databases using ICD‐10 codes. The proportion of patients with cirrhosis and HCC who tested positive for HBV and HCV were calculated to estimate the aetiological fractions. After the pilot study was completed, each site was asked about the feasibility and acceptability of the protocol. A total of 1249 patients presenting with cirrhosis and/or HCC were evaluated across the three sites. The prevalence of HBV and HCV among cases of cirrhosis showed that in Norway and Portugal, HCV was responsible for about one‐quarter of the cases, whereas in Bulgaria, HBV was more common. For HCC, HCV was responsible for more than one‐third of cases in Norway and Portugal, while in Bulgaria HBV was more frequent as the underlying cause. Results obtained during the pilot study were comparable to published estimates obtained through statistical modelling or meta‐analyses. Several challenges were reported from the sites involved in the pilot including the considerable time needed for reviewing the hospital records and extracting patient data. The pilot demonstrated the feasibility of collecting data on the prevalence of HBV and HCV infection among patients with cirrhosis and HCC in sentinel sites. This method can be used to estimate mortality attributable to HBV and HCV for elimination monitoring. Where easily implementable, sentinel studies are the best way to empower countries, get up‐to date data and closely monitor the changes in the attributable fraction at a country level. |
format | Online Article Text |
id | pubmed-9290525 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-92905252022-07-20 Estimating the attributable fraction of cirrhosis and hepatocellular carcinoma due to hepatitis B and C Duffell, Erika Cortez‐Pinto, Helena Simonova, Marieta Dalgard, Olav Dahl, Elin Hoffmann de Martel, Catherine Mozalevskis, Antons Buti, Maria Pavlova, Slava Hadzhilova, Tnaiq Simões, Carolina Katzarov, Krum Mardh, Otilia J Viral Hepat Original Articles A goal of the WHO strategy on the elimination of hepatitis as a public threat is a 65% reduction in the attributable mortality. Deaths related to hepatitis B and C infections are mostly due to decompensated cirrhosis and hepatocellular carcinoma (HCC) but accurately measuring mortality is challenging as death certificates often do not capture the underlying disease. The aim of this collaborative study between European Centre for Disease Prevention and Control (ECDC) and the European Association for the Study of the Liver (EASL) was to assess a WHO‐developed protocol to support countries in implementing studies to collect data on the fraction of cirrhosis and hepatocellular carcinoma attributable to hepatitis B and C. Three sentinel sites (in Bulgaria, Norway and Portugal) collected data for patients first admitted or seen in their centres during 2016. Patients with cirrhosis or HCC were identified through patient files or healthcare databases using ICD‐10 codes. The proportion of patients with cirrhosis and HCC who tested positive for HBV and HCV were calculated to estimate the aetiological fractions. After the pilot study was completed, each site was asked about the feasibility and acceptability of the protocol. A total of 1249 patients presenting with cirrhosis and/or HCC were evaluated across the three sites. The prevalence of HBV and HCV among cases of cirrhosis showed that in Norway and Portugal, HCV was responsible for about one‐quarter of the cases, whereas in Bulgaria, HBV was more common. For HCC, HCV was responsible for more than one‐third of cases in Norway and Portugal, while in Bulgaria HBV was more frequent as the underlying cause. Results obtained during the pilot study were comparable to published estimates obtained through statistical modelling or meta‐analyses. Several challenges were reported from the sites involved in the pilot including the considerable time needed for reviewing the hospital records and extracting patient data. The pilot demonstrated the feasibility of collecting data on the prevalence of HBV and HCV infection among patients with cirrhosis and HCC in sentinel sites. This method can be used to estimate mortality attributable to HBV and HCV for elimination monitoring. Where easily implementable, sentinel studies are the best way to empower countries, get up‐to date data and closely monitor the changes in the attributable fraction at a country level. John Wiley and Sons Inc. 2021-06-08 2021-08 /pmc/articles/PMC9290525/ /pubmed/34003542 http://dx.doi.org/10.1111/jvh.13545 Text en © 2021 The Authors. Journal of Viral Hepatitis published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Articles Duffell, Erika Cortez‐Pinto, Helena Simonova, Marieta Dalgard, Olav Dahl, Elin Hoffmann de Martel, Catherine Mozalevskis, Antons Buti, Maria Pavlova, Slava Hadzhilova, Tnaiq Simões, Carolina Katzarov, Krum Mardh, Otilia Estimating the attributable fraction of cirrhosis and hepatocellular carcinoma due to hepatitis B and C |
title | Estimating the attributable fraction of cirrhosis and hepatocellular carcinoma due to hepatitis B and C |
title_full | Estimating the attributable fraction of cirrhosis and hepatocellular carcinoma due to hepatitis B and C |
title_fullStr | Estimating the attributable fraction of cirrhosis and hepatocellular carcinoma due to hepatitis B and C |
title_full_unstemmed | Estimating the attributable fraction of cirrhosis and hepatocellular carcinoma due to hepatitis B and C |
title_short | Estimating the attributable fraction of cirrhosis and hepatocellular carcinoma due to hepatitis B and C |
title_sort | estimating the attributable fraction of cirrhosis and hepatocellular carcinoma due to hepatitis b and c |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9290525/ https://www.ncbi.nlm.nih.gov/pubmed/34003542 http://dx.doi.org/10.1111/jvh.13545 |
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