Researchers at Imperial College London and the University of Washington analyzed data from 183 countries between 1990 and 2013, and discovered that viral hepatitis has become a leading cause of death worldwide over the past 23 years, killing as many per year as tuberculosis (TB), malaria or HIV/AIDS.
Viral hepatitis exists as hepatitis A, B, C, D and E. It can be transmitted through body fluids or, for hepatitis A and E, through feces contaminated foods or drinks.
The team found that viral hepatitis-related deaths increased by 63 percent over the course of the 23 years studied. Most deaths (96 percent) were directly related to hepatitis B and C – diseases that can cause liver damage and liver cancer. Hepatitis B and C include symptoms like fatigue or nausea, but many people do not experience symptoms and are unaware of the infection until serious complications arise.
The findings were published in an peer-reviewed article, “The global burden of viral hepatitis from 1990 to 2013: findings from the Global Burden of Disease Study 2013,” published in the July issue of The Lancet. The research study was financed by the Bill and Melinda Gates Foundation.
Results suggested that more people died of viral hepatitis in high and middle-income countries than lower-income countries.
“We explored the relationship between the burden of viral hepatitis and economic status. Viral hepatitis has consistently been ranked as a leading cause of mortality in upper-middle income countries, but a relative rise in mortality in lower-middle income countries has been associated with a narrowing in the rankings by 2013,” said Jeff Stanaway, an assistant professor from the Institute for Health Metrics and Evaluation at the University of Washington, in a press release. “Our results suggest that an evolution in funding structures is required to accommodate viral hepatitis and allow effective responses in low and low-to-middle income countries.”
In 2013 alone, 1.3 million people died of HIV/AIDS; 1.4 million from TB; and 855,000 from malaria, according to a 2015 Institute for Health Metrics and Evaluation study.
In comparison, data from the Global Burden of Diseases project which collects data worldwide on deaths caused by the four major Hepatitis diseases (A, B, C, and E), found that infection and liver disease due to viral hepatitis had caused 63% more deaths in 2013 than in 1990 – from 890,000 to 1.45 million, respectively.
Imperial College study leader Dr. Graham Cooke, from the Department of Medicine, said the study is the most comprehensive analysis to date, it reveals “startling findings,” and hopefully it will cause action worldwide to make treatments affordable.
“Although there are effective treatments and vaccines for viral hepatitis, there is very little money invested in getting these to patients –especially compared to malaria, HIV/AIDS and TB. We now have a viral hepatitis global action plan approved in May by the World Health Assembly, and we now need to implement it,” Cooke said.
The study also showed that most hepatitis-related deaths occurred in East Asia, the majority of which were hepatitis B and C-related. Cooke explained that one possible reason for the high numbers could be that those particular strains cause long-term infections with very few immediate symptoms. They can “run free” to silently trigger serious liver damage or cancer.
“Although we have had an effective hepatitis B vaccine for some years, there is still a large proportion of the world which is unvaccinated. We have no similar vaccine for hepatitis C,” Cooke said. “We have tools at our disposal to treat this disease – we have vaccines to hepatitis A and B, and we have new treatments to C. However the price of new medicines is beyond the reach of any country – rich or poor.”