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 tocirrhosis and hepatocellular carcinoma. The Global Burden of Disease (GBD) study from 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 2010 study. METHODS: We used results of GBD 2010 between 1990 and 2010 for Iran to measure rates and trends for mortality, causes of deaths, years of life lost (YLLs), years lived with disability (YLDs), anddisability-adjusted lifeyears (DALYs). 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. CONCLUSION: 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, acomprehensive study such asthe National and Subnational Burden of Diseases (NASBOD) study would be needed to estimate and calculate precisely prevalence and burden of HCV-related disease at national and subnational levels.