Burden of Hepatitis C in Iran Between 1990 and 2010: findings from the Global Burden of Disease Study 2010.
BACKGROUND
Hepatitis C virus (HCV) is the foremost cause of deaths attributable to cirrhosis and hepatocellular carcinoma. The Global Burden of Disease study 2010 (GBD 2010) quantifies and compares the degree of health loss as a result of diseases, injuries, and risk factors by age, sex, and geography overtime. This study aimed to present and critique the burden of hepatitis C and its trend in Iran between 1990 and 2010 by using the GBD study 2010.


METHODS
We used the results of GBD 2010 for Iran to measure rates and trends of mortality, causes of deaths, years of life lost (YLLs), years lived with disability (YLDs), and disability adjusted life years (DALYs) due to hepatitis C. Hepatitis C was defined as the presence of hepatitis C virus in the serum. Data were presented in three categories: acute hepatitis C, cirrhosis secondary to hepatitis C, and liver cancer secondary to hepatitis C.


RESULTS
HCV infection (including the three categories of the study) led to 57.29, 59.92, and 66.45 DALYs (per 100,000 population) in 1990, 2000, and 2010, respectively. DALYs and death rates showed a slight decreasing trend for HCV cirrhosis; however, DALYs and death rates increased for acute hepatitis and liver cancer due to patients with HCV. The majority of deaths and DALYs were in individuals aged 70 years and above in all three categories of HCV. YLLs made the greatest contributions to DALYs.


CONCLUSIONS
DALYs due to HCV infection are increasing in Iran according to GBD 2010; however, the estimations of DALYs using GBD 2010 are mostly from model-based data and there are significant uncertainties for extrapolated data. In this regard, a comprehensive study such as the National and Subnational Burden of Diseases (NASBOD) study would be needed to estimate and calculate precisely prevalence and burden of HCV-related diseases at national and subnational levels.
1)Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.2)Non-communicable Diseases Research Center, Endocrinology and Metabolism Poopulation Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Hamid
H
Mohaghegh Shalmani
2)Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. 3)Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Research Institute,Tehran University of Medical Sciences, Tehran, Iran.
Atefeh
A
Noori
Regional Knowledge Hub, and WHO Collaborating Centre for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
Mostafa
M
Shokoohi
2)Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. 3)Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Alireza
A
Khajavi
Infectious Diseases and Tropical Medicine Research Center (IDTMRC), AJA University of Medical Sciences, Tehran, Iran.
Mohammad
M
Darvishi
Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Alireza
A
Delavari
School of Medicine, Department Of Pharmacology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Hamid Reza
HR
Jamshidi
2)Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.3)Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Shohreh
S
Naderimagham
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D006233:Persons with Disabilities / Q000706:statistics & numerical data; D005260:Female; D006306:Health Surveys; D019698:Hepatitis C, Chronic / Q000401:mortality*; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000401:mortality* / Q000821:virology; D008113:Liver Neoplasms / Q000401:mortality* / Q000821:virology; D008297:Male; D008875:Middle Aged; D055815:Young Adult