title: Burden of disease related to hepatitis C and hepatitis B in Spain: a methodological challenge of an unfolding health problem.
abstract: Most previous studies of burden of disease (BoD) in the area of transmissible diseases have assessed the burden of hepatitis C and B without including the end stages of the disease and using an incident approach. We aimed to assess the disability-adjusted life years (DALYs) related to hepatitis C and B in Spain in 2006 taking into account related cirrhosis and liver cancer. A prevalence approach was used to estimate current years lived with disability (YLD) because of viral hepatitis contracted years/decades before. We added years of life lost (YLL) to obtain DALYs. Around 76,000 DALYs were attributed to hepatitis C virus (HCV) and 15,323 to hepatitis B virus (HBV) when calculated without applying social values. Applying the discount rate and age-weighting used in the Global Burden Disease study, the BoD nearly halved. In any case, the burden related to hepatitis C including long-term outputs becomes the leading cause of DALYs among transmissible diseases in Spain. The mortality component (YLL) represents more than 90% of the BoD in both HCV and HBV. The findings emphasize the need to provide good surveillance systems not only concerning acute viral hepatitis, but also chronic and end-stage consequences to allow a reliable assessment of the prevention and public health control policies.
authors.affiliation: Epidemiology Department, Regional Health Council, Murcia, Spain.
authors.forename: A
authors.initials: A
authors.lastname: García-Fulgueiras
authors.forename: R
authors.initials: R
authors.lastname: García-Pina
authors.forename: C
authors.initials: C
authors.lastname: Morant
authors.forename: N Fernández
authors.initials: NF
authors.lastname: de Larrea-Baz
authors.forename: E
authors.initials: E
authors.lastname: Alvarez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D006509:Hepatitis B / Q000150:complications / Q000453:epidemiology*; D006526:Hepatitis C / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D008103:Liver Cirrhosis / Q000150:complications / Q000453:epidemiology*; D008113:Liver Neoplasms / Q000150:complications / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D013030:Spain / Q000453:epidemiology; D055815:Young Adult