Sensitivity Analysis of Hepatitis B and C Mortality in England Using Data Linkage: Meeting the WHO Elimination Threshold for Mortality

IF 2.3 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Annabel A. Powell, Annastella Costella, Rachel Roche, David Leeman, Ashley Brown, Beatrice Emmanouil, Mark Gillyon-Powell, Ross Harris, Holly D. Mitchell, Ruth Simmons, Monica Desai
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Abstract

The United Kingdom, along with many other countries, is working towards eliminating viral hepatitis as a public health threat by 2030, with a combined mortality target of less than or equal to six deaths per 100,000 population. The current methodology of reporting uses death registrations alone, which has been estimated to underestimate mortality rates by up to 60% for hepatitis C (HCV)-related liver disease. We aim to conduct a sensitivity analysis using data linkage of death certificates, hepatitis B (HBV) and HCV diagnoses and admissions for end-stage liver disease (ESLD) and/or hepatocellular carcinoma (HCC) to estimate mortality rates, assess progress towards elimination and evaluate underreporting. Between 2000 and 2023, 7967 deaths were reported due to HBV- and/or HCV-associated ESLD and/or HCC. Using data linkage of all three datasets, this increased to 11,487, with underreporting estimated to be 37% overall. The upper bound combined mortality rate was estimated to be 1.3 deaths per 100,000 population at its peak in 2015, therefore surpassing the WHO target for all years evaluated. From 2015 to 2023, both HCV-associated ESLD and/or HCC mortality decreased (1.12 to 0.88 deaths per 100,000 population), however, there was a slight increase for HBV-associated ESLD and/or HCC deaths during the same time frame (0.3 to 0.35). A higher proportion of HBV-related deaths were in males (p < 0.05) who died outside London (p < 0.05) and a lower proportion were White (p < 0.05) when compared to HCV-related deaths. While England has met the WHO impact targets, it is important we continue to drive reductions in mortality.

Abstract Image

使用数据链接对英国乙型肝炎和丙型肝炎死亡率的敏感性分析:达到WHO的死亡率消除阈值
联合王国与许多其他国家一道,正在努力到2030年消除作为公共卫生威胁的病毒性肝炎,总死亡率目标是每10万人中死亡人数不超过6人。目前的报告方法仅使用死亡登记,据估计,这种方法将丙型肝炎(HCV)相关肝病的死亡率低估了高达60%。我们的目标是使用死亡证明、乙型肝炎(HBV)和丙型肝炎(HCV)诊断和终末期肝病(ESLD)和/或肝细胞癌(HCC)入院的数据链接进行敏感性分析,以估计死亡率、评估消除进展和评估漏报。2000年至2023年间,7967例死亡报告是由于HBV和/或hcv相关的ESLD和/或HCC。使用所有三个数据集的数据链接,这一数字增加到11,487,估计漏报总数为37%。综合死亡率的上限估计在2015年达到峰值,为每10万人1.3例死亡,因此超过世卫组织所评估的所有年份的目标。从2015年到2023年,hcv相关ESLD和/或HCC死亡率均下降(每10万人死亡1.12例至0.88例),然而,在同一时间段内,hbv相关ESLD和/或HCC死亡率略有上升(0.3例至0.35例)。与hcv相关死亡相比,在伦敦以外地区死亡的男性(p < 0.05)中与hbv相关死亡的比例较高(p < 0.05),白人(p < 0.05)的比例较低(p < 0.05)。虽然英格兰已经达到了世卫组织的影响目标,但重要的是我们要继续推动降低死亡率。
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来源期刊
Journal of Viral Hepatitis
Journal of Viral Hepatitis 医学-病毒学
CiteScore
6.00
自引率
8.00%
发文量
138
审稿时长
1.5 months
期刊介绍: The Journal of Viral Hepatitis publishes reviews, original work (full papers) and short, rapid communications in the area of viral hepatitis. It solicits these articles from epidemiologists, clinicians, pathologists, virologists and specialists in transfusion medicine working in the field, thereby bringing together in a single journal the important issues in this expanding speciality. The Journal of Viral Hepatitis is a monthly journal, publishing reviews, original work (full papers) and short rapid communications in the area of viral hepatitis. It brings together in a single journal important issues in this rapidly expanding speciality including articles from: virologists; epidemiologists; clinicians; pathologists; specialists in transfusion medicine.
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