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The global burden of liver disease attributable to hepatitis B, hepatitis C, and alcohol: increasing mortality, differing causes
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Reported by Jules Levin
AASLD 2013 Nov 1-4 Wash DC
From Jules: Liver disease generally, and viral hepatitis specifically, has been neglected in global public health responses and funding relative to the attributable population health burden......This is especially apparent given that liver cancer is the third most common cause of cancer death globally.......Previous Global Burden of Disease (GBD) Study estimates did not categorise deaths from cirrhosis or liver cancer to
their ultimate causes.....For the first time, GBD 2010 categorically assessed deaths attributable to viral hepatitis and other causes as separate
determinants of death due to cirrhosis and liver cancer......revealing chronic viral hepatitis is the 9th leading cause of death globally......Global deaths - cirrhosis and liver cancer, 2010: 750,000 liver cancer deaths and 1.03 million cirrhosis deaths, Total deaths increased from 1.25 to 1.75 million per year, An increasing proportion due to liver cancer, HBV associated with 45% of liver cancer & 30% of cirrhosis, HCV and alcohol each cause approximately 25% of deaths.....in the USA: An estimated 19,500 liver cancer and 49,500 cirrhosis deaths in 2010, Total deaths increased from 45,000 to 70,000 over 20 years; HCV: 41% of liver cancer & 40% of cirrhosis deaths in 2010; Alcohol: 29% of cancer & 39% cirrhosis; HBV less common.....in China: 370,000 liver cancer & 110,000 cirrhosis deaths in 2010, China estimated to represent half the global burden of liver
cancer deaths, but 11% of the total for cirrhosis, Large increase in liver cancer associated with HBV; HBV: 54% of liver cancer and 46% of cirrhosis deaths.......in Sub-Saharan Africa: 45,000 liver cancer and 103,000 cirrhosis deaths in 2010; Cirrhosis predominant, especially associated with HBV; HBV: 47% of liver cancer and 39% of cirrhosis deaths; Disproportionate burden of 'other cirrhosis' deaths......in Australia: Total deaths increased ~60% over 20 years; As in the USA, cirrhosis deaths predominate; but liver cancer from HBV increasing relatively rapidly; Discordant leading causes: HBV associated with 41% of liver cancer, alcohol 38% of cirrhosis deaths [causes of death due to chronic liver disease due to HCV: 24% liver cancer; 22% HCV-related cirrhosis]........In many regions, viral hepatitis related cirrhosis and liver cancer lead to substantially more deaths than does HIV/AIDS
Benjamin Cowie1-3 & Jennifer MacLachlan1,3
Epidemiology Unit, WHO Regional Reference Laboratory for Hepatitis B, VIDRL
Victorian Infectious Diseases Service, Royal Melbourne Hospital
Department of Medicine, University of Melbourne
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