2010 年至 2019 年与乙型肝炎病毒和丙型肝炎病毒相关的特定原

StephenW

AASLD 2021 十一月 12-15

Nicolette Veracruz，中密歇根大学医学院，Robert G. Gish，美国乙型肝炎基金会，Ramsey C. Cheung，胃肠病学和肝病学部，退伍军人事务部 Palo Alto Health Care；胃肠病学和肝病科，斯坦福大学医学中心医学系和 Robert J. Wong，胃肠病学和肝病学，退伍军人事务部 Palo Alto 医疗保健系统；胃肠病学和肝病学，斯坦福大学医学院

背景：乙型肝炎病毒 (HBV) 和丙型肝炎病毒 (HCV) 感染导致显着的全球发病率和死亡率。尽管有有效的抗病毒疗法，但及时诊断和与护理联系方面的差异阻碍了全球消除进展，导致疾病持续进展和死亡率。我们旨在评估 HBV 和 HCV 相关死亡率和残疾调整生命年 (DALY) 的全球趋势。

方法：评估了 2010-2019 年全球疾病负担、损伤和风险因素研究，以确定 HBV 或 HCV 患者的总体死亡率和 DALY，按急性感染、肝硬化或肝细胞癌 (HCC) 分层。 DALY 计算为因过早死亡而损失的生命年数和残疾年数的总和。死亡率和 DALYs 估计值是年龄标准化的，2010 年至 2019 年的百分比变化按年龄和性别分层。

结果：从 2010 年到 2019 年，观察到 HBV 肝硬化（-11.8%，95% CI -16.5 至 -6.1，p<0.05）和急性 HCV（-26.1%，95% CI -40.5 至-3.9，p<0.05)。然而，观察到 HBV-HCC（14.4%，95% CI 1.7-29.0，p<0.05）、HCV 肝硬化（7.5%，95% CI 3.3-12.1，p<0.05）和 HCV 患者的死亡率显着增加-HCC（15.3%，95% CI 10.6-21.1，p<0.05）。当按性别分层时，男性的 HBV-HCC（16.7%，p<0.05）、HCV 肝硬化（8.3%，p<0.01）和 HCV-HCC（16.5%，p<0.05）死亡率显着增加。女性的 HBV 肝硬化死亡率显着下降（-10.0%，p<0.05），但观察到 HCV 肝硬化和 HCV-HCC 死亡率增加。当按年龄分层时，25-49 岁的成年人 HCV 肝硬化和 HCV-HCC 死亡率显着增加，而 50-69 岁和年龄 >70 岁的成年人 HBV 肝硬化死亡率显着下降（表）。从 2010 年到 2019 年，HBV 对成人急性 HBV 和 HBV 肝硬化的 DALYs 的影响分别下降了 14.2% 和 6.7%，但对 HBV-HCC 的影响增加了 20.5%。同样，急性 HCV 的 DALYs 降低了 28.4%，但成人 HCV 肝硬化和 HCV-HCC 的 DALYs 分别增加了 12.2% 和 21.6%。

结论：虽然观察到 HBV 肝硬化和急性 HCV 的死亡率和 DALY 总体下降，但 HBV-HCC、HCV 肝硬化和 HCV-HCC 导致的死亡率持续上升令人担忧，尤其是在年轻的 HCV 患者中。

StephenW

GLOBAL TRENDS IN CAUSE-SPECIFIC MORTALITY AND DISABILITY ADJUSTED LIFE YEARS RELATED TO HEPATITIS B VIRUS AND HEPATITIS C VIRUS FROM 2010 TO 2019
Conclusion: While overall declines in mortality and DALYs were observed for HBV cirrhosis and acute HCV, continued rise in mortality due to HBV-HCC, HCV cirrhosis, and HCV-HCC is concerning, particularly among younger individuals with HCV.

AASLD 2021 Nov 12-15

Nicolette Veracruz, College of Medicine, Central Michigan University, Robert G. Gish, Hepatitis B Foundation, USA, Ramsey C. Cheung, Division of Gastroenterology and Hepatology, Veterans Affairs Palo Alto Health Care; Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University Medical Center and Robert J. Wong, Gastroenterology and Hepatology, Veterans Affairs Palo Alto Healthcare System; Gastroenterology and Hepatology, Stanford University School of Medicine

Background: Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections contribute to significant global morbidity and mortality. Despite availability of effective antiviral therapies, disparities in timely diagnosis and linkage to care have stalled global elimination progress, leading to continued disease progression and mortality. We aim to evaluate global trends in HBV and HCV related mortality and disability adjusted life years (DALYs).

Methods: The Global Burden of Diseases, Injury, and Risk Factors Study from 2010-2019 was evaluated to determine overall mortality rates and DALYs for patients with HBV or HCV, stratified by acute infection, cirrhosis, or hepatocellular carcinoma (HCC). DALYs were calculated as sum of years of life lost due to premature death and years lived with disability. Mortality and DALYs estimates were age-standardized and percent change from 2010 to 2019 was stratified by age and sex.

Results: From 2010 to 2019, significant declines in mortality were observed for patients with HBV cirrhosis (-11.8%, 95% CI -16.5 to -6.1, p<0.05) and acute HCV (-26.1%, 95% CI -40.5 to -3.9, p<0.05). However, significant increases in mortality were observed for patients with HBV-HCC (14.4%, 95% CI 1.7-29.0, p<0.05), HCV cirrhosis (7.5%, 95% CI 3.3-12.1, p<0.05), and HCV-HCC (15.3%, 95% CI 10.6-21.1, p<0.05). When stratified by sex, men experienced significant increases in mortality for HBV-HCC (16.7%, p<0.05), HCV cirrhosis (8.3%, p<0.01), and HCV-HCC (16.5%, p<0.05). Women experienced significant declines in HBV cirrhosis mortality (-10.0%, p<0.05), but increases in HCV cirrhosis and HCV-HCC mortality were observed. When stratified by age, adults age 25-49y had significantly increased HCV cirrhosis and HCV-HCC mortality, whereas adults age 50-69y and age >70y had significant declines in HBV cirrhosis mortality (Table). From 2010 to 2019, the impact of HBV on DALYs decreased by 14.2% and 6.7% for adults with acute HBV and HBV cirrhosis, respectively, but increased by 20.5% for HBV-HCC. Similarly, DALYs decreased by 28.4% for acute HCV, but increased by 12.2% and 21.6% for adults with HCV cirrhosis and HCV-HCC, respectively.

Conclusion: While overall declines in mortality and DALYs were observed for HBV cirrhosis and acute HCV, continued rise in mortality due to HBV-HCC, HCV cirrhosis, and HCV-HCC is concerning, particularly among younger individuals with HCV.

StephenW

我的意思 -  - 避免肝硬化.