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The global burden of hepatitis E virus genotypes 1 and 2 in 2005
Author(s) -
Rein David B.,
Stevens Gretchen A.,
Theaker Jordan,
Wittenborn John S.,
Wiersma Steven T.
Publication year - 2012
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.25505
Subject(s) - case fatality rate , medicine , hepatitis e virus , asymptomatic , seroprevalence , incidence (geometry) , population , hepatitis e , confidence interval , disease , burden of disease , disease burden , mortality rate , pregnancy , genotype , demography , immunology , environmental health , serology , biology , antibody , biochemistry , physics , genetics , sociology , optics , gene
Abstract We estimated the global burden of hepatitis E virus (HEV) genotypes 1 and 2 in 2005. HEV is an emergent waterborne infection that causes source‐originated epidemics of acute disease with a case fatality rate thought to vary by age and pregnancy status. To create our estimates, we modeled the annual disease burden of HEV genotypes 1 and 2 for 9 of 21 regions defined for the Global Burden of Diseases, Injuries, and Risk Factors Study (the GBD 2010 Study), which represent 71% of the world's population. We estimated the seroprevalence of anti‐HEV antibody and annual incidence of infection for each region using data from 37 published national studies and the DISMOD 3, a generic disease model designed for the GBD Study. We converted incident infections into three mutually exclusive results of infection: (1) asymptomatic episodes, (2) symptomatic disease, and (3) death from HEV. We also estimated incremental cases of stillbirths among infected pregnant women. For 2005, we estimated 20.1 (95% credible interval [Cr.I.]: 2.8‐37.0) million incident HEV infections across the nine GBD Regions, resulting in 3.4 (95% Cr.I.: 0.5‐6.5) million symptomatic cases, 70,000 (95% Cr.I.: 12,400‐132,732) deaths, and 3,000 (95% Cr.I.: 1,892‐4,424) stillbirths. We estimated a probability of symptomatic illness given infection of 0.198 (95% Cr.I.: 0.167‐0.229) and a probability of death given symptomatic illness of 0.019 (95% Cr.I.: 0.017‐0.021) for nonpregnant cases and 0.198 (95% Cr.I.: 0.169‐0.227) for pregnant cases. Conclusion : The model was most sensitive to estimates of age‐specific incidence of HEV disease. (H EPATOLOGY 2012)