0000064967 00000 n Chronic hepatitis B virus (HBV) is the ninth leading cause of death, with approximately 300 million chronic carriers of HBV worldwide. In 2006, an estimated 63-73 million inactive carriers made up the largest group [4-6]. Ideal scenario 2 mainly represented expanded treatment eligibility. We used a modification o … Based on these data, approximately 93 million people were chronically infected with HBV. Chronic HDV infection is the most severe form of viral hepatitis and can have mortality rates as high as 50% within five years in cirrhotic patients. 403 0 obj <>stream Woo G, Tomlinson G, Nishikawa Y, Kowgier M, Sherman M, Wong DK, et al. 0000004598 00000 n World Health Organization. People living with chronic HBV infection can be classified into several categories according to serum markers and liver function [3, 4], including immune-tolerant carriers, inactive carriers, HBeAg-positive hepatitis, and HBeAg-negative hepatitis. 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The cumulative and annual incidence of HBV-related complications and deaths are presented in Fig. The five scenarios were as follows: 1) Natural history scenario: No interventions (diagnosis or treatment) were applied; 2) Base case scenario: The current diagnosis and treatment rate simulated were applied from 2004 to 2050; 3) WHO-proposed target scenario: Gradually increased diagnosis and treatment rates and a reduction in the number of new infections were proposed by the WHO, which illustrated an improved diagnosis/treatment rate (Supplementary Tables 3 and 6); 4) Ideal scenario 1—full capacity of diagnosis and treatment: This scenario simulated that all existing HBV-infected patients would be diagnosed, and all treatment-eligible patients could receive and benefit from NA therapy, but annual new infection cases and treatment eligibility were not changed compared with those of the WHO target scenario (Supplementary Table 3); and 5) Ideal case 2—full treatment eligibility: This scenario simulated that all hepatitis and cirrhosis patients were treatment-eligible, but the annual new infection number, diagnosis rate, and treatment rate were unchanged compared with those of the WHO target scenario (Supplementary Tables 3 and 6). Among them, ideal scenarios 1 and 2 were predicted to have the lowest disease burden of complications and chronic infections. 0000072108 00000 n Higher viral loads are associated with an . Model construction methods; B. In addition, this comprehensive handbook reveals cutting-edge research on the dangers of hepatitis C, one of the world's fasting-growing microbial threats. Assessed 10 May 2019. Aims. Complications of chronic hepatitis B. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. In 2006, an estimated 63–73 million inactive carriers made up the largest group [4,5,6]. This study was funded in part by the Mega-Project of National Science and Technology for the 13th Five-Year Plan of China (grant number 2018ZX10715013–003-003); the Key Joint Project for Data Center of the National Natural Science Foundation of China (grant number U1611264); and the Mega-Project of National Science and Technology of China (grant number 2018ZX10715014002). WHO estimates that in 2016, 7134 persons died from hepatitis A worldwide (accounting for 0.5% of the mortality due to viral hepatitis). 0000042031 00000 n 2014;12:145. https://doi.org/10.1186/s12916-014-0145-y. The burden of chronic hepatitis C in China from 2004 to 2050: an individual-based modeling study. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. 2016. https://www.who.int/hepatitis/strategy2016-2021/ghss-hep/en/. Acute hepatitis C occurs within the first 6 months after someone . 2000;29(4):744–52. Symptoms. 0000016379 00000 n This book is a concise guide to the prevention and management of cirrhosis of the liver. Liver failure from chronic hepatitis C infection is the most common reason for liver transplantation in the U.S. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Hepatitis can be acute (short-term) or chronic (long-term) and can have fatal complications. Although incidence of all-cause mortality increased from 1.8% in 2006 to 2.9% in 2015, a join-point was identified at 2010, with aAPCs of 9.6 before (2006 < 2010; p < .01) and −5.2 after (2010 ≤ 2015; p < .01), indicating a decrease in mortality from 2010 and onward. Therefore, our study developed an individual-level Markov model aiming to project the disease burden of total chronic HBV infections, cirrhosis, DC, HCC, LT, and HBV-related death from 2006 to 2050 under various scenarios representing different levels of diagnosis, treatment rates, treatment eligibility, and annual new infections. 2016;16(1):80–6. It is estimated that at least 12 million people worldwide are currently co-infected with HDV and HBV. Hep C damages your liver in an ongoing, chronic way, and every time your liver goes to repair itself, there is a risk for a cell mutation to occur, upping your risk for liver cancer. 0000025781 00000 n https://doi.org/10.1002/hep.26041. Autoimmune hepatitis that goes untreated can cause permanent scarring of the liver tissue (cirrhosis). This review assesses the comparative effectiveness of antiviral treatments in adults with chronic HCV infection who have not received previous antiviral drug treatment. Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance. Hepatitis B Virus (HBV) is a type of virus that affects the liver. Even with the help of Peg-IFN therapy, 3–7% of patients would lose HBsAg, far less than 97% of HCV elimination using DAAs [3, 48, 49]. 0000010825 00000 n As cirrhosis gets worse, the liver begins to fail. We did not use different strategies for HBV vaccination in our model because it has already been covered universally, with more than 95% coverage at present, and the blocking of vertical transmission is also highly effective, with an incidence of less than 10/100,000 new HBV infections [30, 31]. We aimed to project the disease burden of chronic hepatitis B virus (HBV) infection and related complications by modeling various scenarios. https://doi.org/10.1111/j.1365-2893.2010.01266.x. We validated our model’s results using authoritative public health data sources, which included the following: the annual cirrhosis and DC incidence from the Institute for Health Metrics and Evaluation (IHME) Global Health Data Exchange (GHDx) online database; the annual HCC incidence from WHO CI5plus/IARC 2010–2012, WHO Globocan 2018, Polaris online database; the annual HBV-related death with WHO Globocan 2018 online database; the annual LT incidence from the China Liver Transplant Registry (CLTR) online database [32,33,34,35,36]; the annual number of cirrhosis deaths from published global disease burden studies [37, 38]; and the total chronic HBV infection prevalence from studies published by Chinese hepatology experts for the base case scenario [22]. Assesed 20 Jun 2020. Chronic Hepatitis B Infection. Virol J 17, 132 (2020). 0000012952 00000 n Lancet Infect Dis. DC = decompensated cirrhosis; HCC = hepatocellular carcinoma; LT = liver transplantation. Chronic hepatitis B complications. World Health Organization; International Agency for Research on Cancer. Discusses all aspects of viral hepatitis, from structure and molecular virology, and natural history and experimental models, to epidemiology, diagnosis and prevention. If you've never been vaccinated against hepatitis A, you need 2 doses of this vaccine, usually spaced 6-18 months apart. Lim SG, Aghemo A, Chen PJ, Dan YY, Gane E, Gani R, et al. Sharma SK, Saini N, Chwla Y. PubMed complications of chronic liver disease. Wang SF, Chen XP. This number decreased to 16.89 million under the base case and dropped even lower to 15.13 million, 14.77 million, and 14.46 million under scenarios 3–5. In this book, the authors describe the physiopathology of the diverse causes of ascites,the types of treatments recommended, the recent advances achieved, the complications and the prognosis of the different clinical situations that doctors ... World J Gastroenterol. https://doi.org/10.1002/hep.29498. However, there are still several problems with diagnosis and treatment in China and worldwide. In the United States there are an estimated 1.2 million chronic carriers, accounting for roughly 17,000 hospitalizations and 5,500 deaths each year. 2020. http://www.cltr.org/pages/statistics/statistics_livercount.jsp. 0000002468 00000 n https://doi.org/10.1093/pubmed/fdy015. 0000003393 00000 n To improve these problems, both the WHO and China have mentioned increasing the diagnosis and treatment rate and reducing new infections in strategies to eliminate viral hepatitis [15]. 0000006331 00000 n <<829A3FE3FAC6A541850A497ED4B79072>]/Prev 143637/XRefStm 2128>> Modeling and analyzing the transmission dynamics of HBV epidemic in Xinjiang, China. h�bbbd`b``Ń3� ������ ��� Sensitivity analysis revealed that 81.75% (327/400) of all predicted upper or lower values of cirrhosis, DC, HCC, LT cumulative incidence and cumulative death fluctuated within 10, and 96% (384/400) fluctuated within 20% (Supplementary Table 9, 10). Epidemiology of hepatitis B and hepatitis C infections and benefits of programs for hepatitis prevention in northeastern China: a cross-sectional study. Unlike hepatitis B and C, hepatitis A does not cause chronic liver disease but it can cause debilitating symptoms and rarely fulminant hepatitis (acute liver failure), which is often fatal. Management of hepatitis C virus infection in the Asia-Pacific region: an update. Cui F, Shen L, Li L, Wang H, Wang F, Bi S, et al. Current HBV screening in China only include childbirth screening and vaccinations, blood product screening, and screening for safe injection practices [41]. Chronic hepatitis C virus (HCV)-related complications have increased over the past decade. Chronic hepatitis C (HCV) involves a range of complications affecting the liver and other organs throughout the body. Certain circumstances and activities may increase the risk for hepatitis D complications. National Bureau of Statistics of China. Dr. Flamm has invited a group of distinguished hepatologists to provide insight into the assessment of a variety of scenarios where clinical judgment based on experience and published literature is an invaluable addition to the care of ... 0000072825 00000 n Hepatitis C is often described as "acute," meaning a new infection, or "chronic," meaning long-term infection. In the United States, screening is recommended for those who are at high risk, including immigrants from places with > 2% prevalence, HIV-infected people, and pregnant women at their first prenatal visits [42, 43]. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The disease is diagnosed by quantifying the levels of HBV DNA, HBsAg and the antigen / antibody ratio. Additionally, the large baseline of the infected population would generate a large disease burden of hepatitis and complications every year, greatly exceeding the number of individual HBsAg losses. We projected that there would be a total of 59.56 million cumulative incidences of HBV-related complications and 27.19 million deaths under the natural history scenario (Supplementary Table 11). The proportions of HBsAg losses in the base case (40.46%), the WHO target scenario (40.01%), ideal scenario 1 (40.71%) and ideal scenario 2 (40.92%) were extremely close, but each exceeded that of the natural history scenario (31.45%) (Table 3). 0000020497 00000 n However, considering the large existing chronic HBV infected population and the low HBsAg loss rate of NA therapy, it is still difficult to avert the increasing trend of cumulative cirrhosis, DC, HCC, LT, and HBV-related death in all scenarios. China: WHO and UNICEF estimates of immunization coverage: 2018 revision. https://doi.org/10.7326/M17-1106. An accurate depiction of the disease burden has not yet been thoroughly conducted. 2017;23(5):765–72. World Health Organization. Methods. endstream endobj 330 0 obj <>/Metadata 6 0 R/Pages 5 0 R/StructTreeRoot 8 0 R/Type/Catalog/ViewerPreferences<>>> endobj 331 0 obj <. Acute Hepatitis B Infection becomes chronic in 10% (higher risk in younger ages) Chronic Hepatitis B ( HBsAg present >6 months) Chronic Hepatitis B Carrier. World Health Organization. Chin J Viral Dis. We defined each annual transition probability using the upper range and lower range values and then compared the upper or lower values of cirrhosis, DC, HCC, and LT cumulative incidence and cumulative death with base-case values (Supplementary S 1.6). The sooner hepatitis C is diagnosed and treatment begins, the lower the risk for serious complications. Hepatitis C (HCV) infection causes an asymptomatic chronic hepatitis in most affected individuals, which often remains undetected until cirrhosis and cirrhosis-related complications occur. CAS Over time, perhaps a decade or more, both types may lead to the serious complication of cirrhosis due to ongoing destruction of liver cells and resultant scarring. Similarly, ideal scenario 2 led to fewer HBV-related deaths and more HBsAg losses than did the WHO-targeted scenario, which proved that increased treatment eligibility was beneficial in reducing the chronic HBV disease burden. Cite this article. cells can repair and regenerate but here they regenerate abnormally into nodules. GBD 2017 Cirrhosis Collaborators. https://doi.org/10.1016/S2468-1253(18)30056-6. We performed a 1-way sensitivity analysis on the model in base-case parameters by considering uncertainty in all probability rates. Over their lifetimes, 15–40% of people with chronic HBV infection can develop complications ranging from hepatocellular carcinoma (HCC) to HBV-related death [9]. Ontarians with chronic hepatitis C can lose up to 20 per cent of their overall income managing their condition, a new study has found. 329 0 obj <> endobj 0000018809 00000 n 0000030892 00000 n New HBV infections after 2006 were added to the simulated population annually based on reports by the Chinese Centers for Disease Control and Prevention, and the age distribution was derived from published data. We also assumed that those who met the treatment criteria in the Chinese Medical Association and Asian Pacific Association for the Study of the Liver (APASL) guidelines for HBeAg-negative hepatitis, HBeAg-positive hepatitis and cirrhosis states could receive NA therapy and achieve a virological response (defined as undetectable serum HBV DNA during therapy), thereafter progressing at different probability rates (see Supplementary Table 5) [4, 29]. 20 Elevated Liver Function Test s (ALT or SGPT) III. Hepatitis C can range from a mild illness lasting a few weeks to a serious, long-term illness. 0000020383 00000 n Zhang T, Wang K, Zhang X. 2005;2:82. https://doi.org/10.1186/1743-422X-2-82. Chu CM, Liaw YF. With improved diagnosis and treatment rates of NA therapy, ideal cases have fewer HBV-related deaths (14.46–14.77 million) than do WHO-proposed cases (15.13 million) and base cases (16.89 million), but the proportion of HBsAg loss is similar among them. Chronic disease diffuse inflammation → scarring. Mokdad AA, Lopez AD, Shahraz S, Lozano R, Mokdad AH, Stanaway J, et al. https://doi.org/10.1186/s12985-020-01393-z, DOI: https://doi.org/10.1186/s12985-020-01393-z. 0000000016 00000 n https://doi.org/10.1016/S1473-3099(16)30327-9. 0000026058 00000 n Liu J, Zhang S, Wang Q, Shen H, Zhang M, Zhang Y, et al. We used join-point regression modelling to investigate trends in these complications from 2006 to 2015, and the impact of demographics on these trends.
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