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1. Global, regional, and national burden of hepatitis B, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

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Sheena, B, Hiebert, L, Han, H, Ippolito, H, Abbasi-Kangevari, M, Abbasi-Kangevari, Z, Abbastabar, H, Abdoli, A, Abubaker Ali, H, Adane, M, Adegboye, O, Adnani, Q, Advani, S, Afzal, M, Afzal, S, Aghaie Meybodi, M, Ahadinezhad, B, Ahinkorah, B, Ahmad, S, Ahmad, T, Ahmadi, S, Ahmed, H, Ahmed, M, Rashid, T, Akalu, G, Aklilu, A, Akram, T, Al Hamad, H, Alahdab, F, Alem, A, Alem, D, Alhalaiqa, F, Alhassan, R, Ali, L, Ali, M, Alimohamadi, Y, Alipour, V, Alkhayyat, M, Almustanyir, S, Al-Raddadi, R, Altawalah, H, Amini, S, Amu, H, Ancuceanu, R, Andrei, C, Andrei, T, Anoushiravani, A, Ansar, A, Anyasodor, A, Arabloo, J, Arab-Zozani, M, Argaw, A, Argaw, Z, Arshad, M, Artamonov, A, Ashraf, T, Atlaw, D, Ausloos, F, Ausloos, M, Azadnajafabad, S, Azangou-Khyavy, M, Azari Jafari, A, Azarian, G, Bagheri, S, Bahadory, S, Baig, A, Banach, M, Barati, N, Barrow, A, Batiha, A, Bejarano Ramirez, D, Belgaumi, U, Berhie, A, Bhagat, D, Bhardwaj, N, Bhardwaj, P, Bhattacharyya, K, Bhojaraja, V, Bijani, A, Biondi, A, Bodicha, B, Bojia, H, Boloor, A, Bosetti, C, Braithwaite, D, Briko, N, Butt, Z, Camera, L, Chakinala, R, Chakraborty, P, Charan, J, Chen, S, Choi, J, Choudhari, S, Chowdhury, F, Chu, D, Chung, S, Cortesi, P, Cowie, B, Culbreth, G, Dadras, O, Dai, X, Dandona, L, Dandona, R, De La Hoz, F, Debela, S, Dedefo, M, Demeke, F, Demie, T, Demissie, G, Derbew Molla, M, Desta, A, Dhamnetiya, D, Dhimal, M, Didehdar, M, Doan, L, Dorostkar, F, Drake, T, Eghbalian, F, Ekholuenetale, M, El Sayed, I, El Sayed Zaki, M, Elhadi, M, Elmonem, M, Elsharkawy, A, Enany, S, Enyew, D, Erkhembayar, R, Eskandarieh, S, Esmaeilzadeh, F, Ezzikouri, S, Farrokhpour, H, Fetensa, G, Fischer, F, Foroutan, M, Gad, M, Gaidhane, A, Gaidhane, S, Galles, N, Gallus, S, Gebremeskel, T, Gebreyohannes, E, Ghadiri, K, Ghaffari, K, Ghafourifard, M, Ghamari, S, Ghashghaee, A, Gholami, A, Gholizadeh, A, Gilani, A, Goel, A, Golechha, M, Goleij, P, Golinelli, D, Gorini, G, Goshu, Y, Griswold, M, Gubari, M, Gupta, B, Gupta, S, Gupta, V, Haddadi, R, Halwani, R, Hamid, S, Hamidi, S, Hanif, A, Haque, S, Harapan, H, Hargono, A, Hariri, S, Hasaballah, A, Hasan, S, Hassanipour, S, Hassankhani, H, Hay, S, Hayat, K, Heidari, G, Herteliu, C, Heyi, D, Hezam, K, Holla, R, Hosseini, M, Hosseinzadeh, M, Hostiuc, M, Househ, M, Huang, J, Hussein, N, Iavicoli, I, Ibitoye, S, Ilesanmi, O, Ilic, I, Ilic, M, Irham, L, Islam, J, Ismail, N, Jacobsen, K, Jadidi-Niaragh, F, Javadi Mamaghani, A, Jayaram, S, Jayawardena, R, Jebai, R, Jha, R, Joseph, N, Joukar, F, Kaambwa, B, Kabir, A, Kabir, Z, Kalhor, R, Kandel, H, Kanko, T, Kantar, R, Karaye, I, Kassa, B, Kemp Bohan, P, Keykhaei, M, Khader, Y, Khajuria, H, Khan, G, Khan, I, Khan, J, Khan, M, Khanali, J, Khater, A, Khatib, M, Khodadost, M, Khoja, A, Khosravizadeh, O, Khubchandani, J, Kim, G, Kim, H, Kim, M, Kim, Y, Kocarnik, J, Kolahi, A, Koteeswaran, R, Kumar, G, La Vecchia, C, Lal, D, Landires, I, Lasrado, S, Lazarus, J, Ledda, C, Lee, D, Lee, S, Lee, Y, Levi, M, Li, J, Lim, S, Lobo, S, Lopukhov, P, Loureiro, J, Maclachlan, J, Magdy Abd El Razek, H, Magdy Abd El Razek, M, Majeed, A, Makki, A, Malekpour, M, Malekzadeh, R, Malik, A, Mansour-Ghanaei, F, Mansournia, M, Martins-Melo, F, Matthews, P, Mendoza, W, Menezes, R, Meretoja, T, Mersha, A, Mestrovic, T, Miller, T, Minh, L, Mirica, A, Mirmoeeni, S, Mirrakhimov, E, Misra, S, Mithra, P, Moazen, B, Mohamadkhani, A, Mohammadi, M, Mohammed, S, Moka, N, Mokdad, A, Moludi, J, Momtazmanesh, S, Monasta, L, Moradi, G, Moradzadeh, M, Moradzadeh, R, Moraga, P, Mostafavi, E, Mubarik, S, Muniyandi, M, Murray, C, Naghavi, M, Naimzada, M, Narasimha Swamy, S, Natto, Z, Nayak, B, Nazari, J, Negoi, I, Negru, S, Nejadghaderi, S, Neupane Kandel, S, Nguyen, H, Ngwa, C, Niazi, R, Nnaji, C, Noubiap, J, Nowroozi, A, Nunez-Samudio, V, Oancea, B, Ochir, C, Odukoya, O, Oh, I, Olagunju, A, Olakunde, B, Omar Bali, A, Omer, E, Otstavnov, S, Oumer, B, Padubidri, J, Pana, A, Pandey, A, Park, E, Pashazadeh Kan, F, Patel, U, Paudel, U, Petcu, I, Piracha, Z, Pollok, R, Postma, M, Pourshams, A, Poustchi, H, Rabiee, M, Rabiee, N, Rafiei, A, Rafiei, S, Raghuram, P, Rahman, M, Rahmani, A, Rahmawaty, S, Rajesh, A, Ranasinghe, P, Rao, C, Rao, S, Rashidi, M, Rawaf, D, Rawaf, S, Rawassizadeh, R, Rezaei, N, Rezapour, A, Rezazadeh-Khadem, S, Rodriguez, J, Rwegerera, G, Sabour, S, Saddik, B, Saeb, M, Saeed, U, Sahebkar, A, Saif-Ur-Rahman, K, Salahi, S, Salimzadeh, H, Sampath, C, Samy, A, Sanabria, J, Sanmarchi, F, Santric-Milicevic, M, Sarveazad, A, Sathian, B, Sawhney, M, Seidu, A, Sepanlou, S, Seylani, A, Shahabi, S, Shaikh, M, Shaker, E, Shakhmardanov, M, Shannawaz, M, Shenoy, S, Shetty, J, Shetty, P, Shibuya, K, Shin, J, Shobeiri, P, Sibhat, M, Singh, A, Singh, J, Singh, S, Skryabin, V, Skryabina, A, Sohrabpour, A, Song, S, Tabaeian, S, Tadesse, E, Taheri, M, Tampa, M, Tan, K, Tavakoli, A, Tbakhi, A, Tefera, B, Tehrani-Banihashemi, A, Tesfaw, H, Thapar, R, Thavamani, A, Tohidast, S, Tollosa, D, Tosti, M, Tovani-Palone, M, Traini, E, Tran, M, Trihandini, I, Tusa, B, Ullah, I, Vacante, M, Valadan Tahbaz, S, Valdez, P, Varthya, S, Vo, B, Waheed, Y, Weldesenbet, A, Woldemariam, M, Xu, S, Yahyazadeh Jabbari, S, Yaseri, M, Yeshaw, Y, Yigit, V, Yirdaw, B, Yonemoto, N, Yu, C, Yunusa, I, Zahir, M, Zaki, L, Zamani, M, Zamanian, M, Zastrozhin, M, Vos, T, Ward, J, Dirac, M, Sheena B. S., Hiebert L., Han H., Ippolito H., Abbasi-Kangevari M., Abbasi-Kangevari Z., Abbastabar H., Abdoli A., Abubaker Ali H., Adane M. M., Adegboye O. A., Adnani Q. E. S., Advani S. M., Afzal M. S., Afzal S., Aghaie Meybodi M., Ahadinezhad B., Ahinkorah B. O., Ahmad S., Ahmad T., Ahmadi S., Ahmed H., Ahmed M. B., Rashid T. A., Akalu G. T., Aklilu A., Akram T., Al Hamad H., Alahdab F., Alem A., Alem D. T., Alhalaiqa F. A. N., Alhassan R. K., Ali L., Ali M. A., Alimohamadi Y., Alipour V., Alkhayyat M., Almustanyir S., Al-Raddadi R. M., Altawalah H., Amini S., Amu H., Ancuceanu R., Andrei C. L., Andrei T., Anoushiravani A., Ansar A., Anyasodor A. E., Arabloo J., Arab-Zozani M., Argaw A. M., Argaw Z. G., Arshad M., Artamonov A. A., Ashraf T., Atlaw D., Ausloos F., Ausloos M., Azadnajafabad S., Azangou-Khyavy M., Azari Jafari A., Azarian G., Bagheri S., Bahadory S., Baig A. A., Banach M., Barati N., Barrow A., Batiha A. -M. M., Bejarano Ramirez D. F., Belgaumi U. I., Berhie A. Y., Bhagat D. S., Bhardwaj N., Bhardwaj P., Bhattacharyya K., Bhojaraja V. S., Bijani A., Biondi A., Bodicha B. B. A., Bojia H. A., Boloor A., Bosetti C., Braithwaite D., Briko N. I., Butt Z. A., Camera L. A., Chakinala R. C., Chakraborty P. A., Charan J., Chen S., Choi J. -Y. J., Choudhari S. G., Chowdhury F. R., Chu D. -T., Chung S. -C., Cortesi P. A., Cowie B. C., Culbreth G. T., Dadras O., Dai X., Dandona L., Dandona R., De La Hoz F. P., Debela S. A., Dedefo M. G., Demeke F. M., Demie T. G. G., Demissie G. D., Derbew Molla M., Desta A. A., Dhamnetiya D., Dhimal M. L., Dhimal M., Didehdar M., Doan L. P., Dorostkar F., Drake T. M., Eghbalian F., Ekholuenetale M., El Sayed I., El Sayed Zaki M., Elhadi M., Elmonem M. A., Elsharkawy A., Enany S., Enyew D. B., Erkhembayar R., Eskandarieh S., Esmaeilzadeh F., Ezzikouri S., Farrokhpour H., Fetensa G., Fischer F., Foroutan M., Gad M. M., Gaidhane A. M., Gaidhane S., Galles N. C., Gallus S., Gebremeskel T. G., Gebreyohannes E. A., Ghadiri K., Ghaffari K., Ghafourifard M., Ghamari S. -H., Ghashghaee A., Gholami A., Gholizadeh A., Gilani A., Goel A., Golechha M., Goleij P., Golinelli D., Gorini G., Goshu Y. A., Griswold M. G., Gubari M. I. M., Gupta B., Gupta S., Gupta V. B., Gupta V. K., Haddadi R., Halwani R., Hamid S. S., Hamidi S., Hanif A., Haque S., Harapan H., Hargono A., Hariri S., Hasaballah A. I., Hasan S. M. M., Hassanipour S., Hassankhani H., Hay S. I., Hayat K., Heidari G., Herteliu C., Heyi D. Z., Hezam K., Holla R., Hosseini M. -S., Hosseini M., Hosseinzadeh M., Hostiuc M., Househ M., Huang J., Hussein N. R., Iavicoli I., Ibitoye S. E., Ilesanmi O. S., Ilic I. M., Ilic M. D., Irham L. M., Islam J. Y., Ismail N. E., Jacobsen K. H., Jadidi-Niaragh F., Javadi Mamaghani A., Jayaram S., Jayawardena R., Jebai R., Jha R. P., Joseph N., Joukar F., Kaambwa B., Kabir A., Kabir Z., Kalhor R., Kandel H., Kanko T. K. T., Kantar R. S., Karaye I. M., Kassa B. G., Kemp Bohan P. M., Keykhaei M., Khader Y. S., Khajuria H., Khan G., Khan I. A., Khan J., Khan M. A., Khanali J., Khater A. M., Khatib M. N., Khodadost M., Khoja A. T., Khosravizadeh O., Khubchandani J., Kim G. R., Kim H., Kim M. S., Kim Y. J., Kocarnik J. M., Kolahi A. -A., Koteeswaran R., Kumar G. A., La Vecchia C., Lal D. K., Landires I., Lasrado S., Lazarus J. V., Ledda C., Lee D. W., Lee S. -W., Lee Y. Y., Levi M., Li J., Lim S. S., Lobo S. W., Lopukhov P. D., Loureiro J. A., MacLachlan J. H., Magdy Abd El Razek H., Magdy Abd El Razek M., Majeed A., Makki A., Malekpour M. -R., Malekzadeh R., Malik A. A., Mansour-Ghanaei F., Mansournia M. A., Martins-Melo F. R., Matthews P. C., Mendoza W., Menezes R. G., Meretoja T. J., Mersha A. G., Mestrovic T., Miller T. R., Minh L. H. N., Mirica A., Mirmoeeni S., Mirrakhimov E. M., Misra S., Mithra P., Moazen B., Mohamadkhani A., Mohammadi M., Mohammed S., Moka N., Mokdad A. H., Moludi J., Momtazmanesh S., Monasta L., Moradi G., Moradzadeh M., Moradzadeh R., Moraga P., Mostafavi E., Mubarik S., Muniyandi M., Murray C. J. L., Naghavi M., Naimzada M. D., Narasimha Swamy S., Natto Z. S., Nayak B. P., Nazari J., Negoi I., Negru S. M., Nejadghaderi S. A., Neupane Kandel S., Nguyen H. L. T., Ngwa C. H., Niazi R. K., Nnaji C. A., Noubiap J. J., Nowroozi A., Nunez-Samudio V., Oancea B., Ochir C., Odukoya O. O., Oh I. -H., Olagunju A. T., Olakunde B. O., Omar Bali A., Omer E., Otstavnov S. S., Oumer B., Padubidri J. R., Pana A., Pandey A., Park E. -C., Pashazadeh Kan F., Patel U. K., Paudel U., Petcu I. -R., Piracha Z. Z., Pollok R. C. G., Postma M. J., Pourshams A., Poustchi H., Rabiee M., Rabiee N., Rafiei A., Rafiei S., Raghuram P. M., Rahman M., Rahmani A. M., Rahmawaty S., Rajesh A., Ranasinghe P., Rao C. R., Rao S. J., Rashidi M., Rashidi M. -M., Rawaf D. L., Rawaf S., Rawassizadeh R., Rezaei N., Rezapour A., Rezazadeh-Khadem S., Rodriguez J. A. B., Rwegerera G. M., Sabour S., Saddik B., Saeb M. R., Saeed U., Sahebkar A., Saif-Ur-Rahman K. M., Salahi S., Salimzadeh H., Sampath C., Samy A. M., Sanabria J., Sanmarchi F., Santric-Milicevic M. M., Sarveazad A., Sathian B., Sawhney M., Seidu A. -A., Sepanlou S. G., Seylani A., Shahabi S., Shaikh M. A., Shaker E., Shakhmardanov M. Z., Shannawaz M., Shenoy S. M., Shetty J. K., Shetty P. H., Shibuya K., Shin J. I., Shobeiri P., Sibhat M. M., Singh A. D., Singh J. A., Singh S., Skryabin V. Y., Skryabina A. A., Sohrabpour A. A., Song S., Tabaeian S. P., Tadesse E. G., Taheri M., Tampa M., Tan K. -K., Tavakoli A., Tbakhi A., Tefera B. N., Tehrani-Banihashemi A., Tesfaw H. M., Thapar R., Thavamani A., Tohidast S. A., Tollosa D. N., Tosti M. E., Tovani-Palone M. R., Traini E., Tran M. T. N., Trihandini I., Tusa B. S., Ullah I., Vacante M., Valadan Tahbaz S., Valdez P. R., Varthya S. B., Vo B., Waheed Y., Weldesenbet A. B., Woldemariam M., Xu S., Yahyazadeh Jabbari S. H., Yaseri M., Yeshaw Y., Yigit V., Yirdaw B. W., Yonemoto N., Yu C., Yunusa I., Zahir M., Zaki L., Zamani M., Zamanian M., Zastrozhin M. S., Vos T., Ward J. W., Dirac M. A., Sheena, B, Hiebert, L, Han, H, Ippolito, H, Abbasi-Kangevari, M, Abbasi-Kangevari, Z, Abbastabar, H, Abdoli, A, Abubaker Ali, H, Adane, M, Adegboye, O, Adnani, Q, Advani, S, Afzal, M, Afzal, S, Aghaie Meybodi, M, Ahadinezhad, B, Ahinkorah, B, Ahmad, S, Ahmad, T, Ahmadi, S, Ahmed, H, Ahmed, M, Rashid, T, Akalu, G, Aklilu, A, Akram, T, Al Hamad, H, Alahdab, F, Alem, A, Alem, D, Alhalaiqa, F, Alhassan, R, Ali, L, Ali, M, Alimohamadi, Y, Alipour, V, Alkhayyat, M, Almustanyir, S, Al-Raddadi, R, Altawalah, H, Amini, S, Amu, H, Ancuceanu, R, Andrei, C, Andrei, T, Anoushiravani, A, Ansar, A, Anyasodor, A, Arabloo, J, Arab-Zozani, M, Argaw, A, Argaw, Z, Arshad, M, Artamonov, A, Ashraf, T, Atlaw, D, Ausloos, F, Ausloos, M, Azadnajafabad, S, Azangou-Khyavy, M, Azari Jafari, A, Azarian, G, Bagheri, S, Bahadory, S, Baig, A, Banach, M, Barati, N, Barrow, A, Batiha, A, Bejarano Ramirez, D, Belgaumi, U, Berhie, A, Bhagat, D, Bhardwaj, N, Bhardwaj, P, Bhattacharyya, K, Bhojaraja, V, Bijani, A, Biondi, A, Bodicha, B, Bojia, H, Boloor, A, Bosetti, C, Braithwaite, D, Briko, N, Butt, Z, Camera, L, Chakinala, R, Chakraborty, P, Charan, J, Chen, S, Choi, J, Choudhari, S, Chowdhury, F, Chu, D, Chung, S, Cortesi, P, Cowie, B, Culbreth, G, Dadras, O, Dai, X, Dandona, L, Dandona, R, De La Hoz, F, Debela, S, Dedefo, M, Demeke, F, Demie, T, Demissie, G, Derbew Molla, M, Desta, A, Dhamnetiya, D, Dhimal, M, Didehdar, M, Doan, L, Dorostkar, F, Drake, T, Eghbalian, F, Ekholuenetale, M, El Sayed, I, El Sayed Zaki, M, Elhadi, M, Elmonem, M, Elsharkawy, A, Enany, S, Enyew, D, Erkhembayar, R, Eskandarieh, S, Esmaeilzadeh, F, Ezzikouri, S, Farrokhpour, H, Fetensa, G, Fischer, F, Foroutan, M, Gad, M, Gaidhane, A, Gaidhane, S, Galles, N, Gallus, S, Gebremeskel, T, Gebreyohannes, E, Ghadiri, K, Ghaffari, K, Ghafourifard, M, Ghamari, S, Ghashghaee, A, Gholami, A, Gholizadeh, A, Gilani, A, Goel, A, Golechha, M, Goleij, P, Golinelli, D, Gorini, G, Goshu, Y, Griswold, M, Gubari, M, Gupta, B, Gupta, S, Gupta, V, Haddadi, R, Halwani, R, Hamid, S, Hamidi, S, Hanif, A, Haque, S, Harapan, H, Hargono, A, Hariri, S, Hasaballah, A, Hasan, S, Hassanipour, S, Hassankhani, H, Hay, S, Hayat, K, Heidari, G, Herteliu, C, Heyi, D, Hezam, K, Holla, R, Hosseini, M, Hosseinzadeh, M, Hostiuc, M, Househ, M, Huang, J, Hussein, N, Iavicoli, I, Ibitoye, S, Ilesanmi, O, Ilic, I, Ilic, M, Irham, L, Islam, J, Ismail, N, Jacobsen, K, Jadidi-Niaragh, F, Javadi Mamaghani, A, Jayaram, S, Jayawardena, R, Jebai, R, Jha, R, Joseph, N, Joukar, F, Kaambwa, B, Kabir, A, Kabir, Z, Kalhor, R, Kandel, H, Kanko, T, Kantar, R, Karaye, I, Kassa, B, Kemp Bohan, P, Keykhaei, M, Khader, Y, Khajuria, H, Khan, G, Khan, I, Khan, J, Khan, M, Khanali, J, Khater, A, Khatib, M, Khodadost, M, Khoja, A, Khosravizadeh, O, Khubchandani, J, Kim, G, Kim, H, Kim, M, Kim, Y, Kocarnik, J, Kolahi, A, Koteeswaran, R, Kumar, G, La Vecchia, C, Lal, D, Landires, I, Lasrado, S, Lazarus, J, Ledda, C, Lee, D, Lee, S, Lee, Y, Levi, M, Li, J, Lim, S, Lobo, S, Lopukhov, P, Loureiro, J, Maclachlan, J, Magdy Abd El Razek, H, Magdy Abd El Razek, M, Majeed, A, Makki, A, Malekpour, M, Malekzadeh, R, Malik, A, Mansour-Ghanaei, F, Mansournia, M, Martins-Melo, F, Matthews, P, Mendoza, W, Menezes, R, Meretoja, T, Mersha, A, Mestrovic, T, Miller, T, Minh, L, Mirica, A, Mirmoeeni, S, Mirrakhimov, E, Misra, S, Mithra, P, Moazen, B, Mohamadkhani, A, Mohammadi, M, Mohammed, S, Moka, N, Mokdad, A, Moludi, J, Momtazmanesh, S, Monasta, L, Moradi, G, Moradzadeh, M, Moradzadeh, R, Moraga, P, Mostafavi, E, Mubarik, S, Muniyandi, M, Murray, C, Naghavi, M, Naimzada, M, Narasimha Swamy, S, Natto, Z, Nayak, B, Nazari, J, Negoi, I, Negru, S, Nejadghaderi, S, Neupane Kandel, S, Nguyen, H, Ngwa, C, Niazi, R, Nnaji, C, Noubiap, J, Nowroozi, A, Nunez-Samudio, V, Oancea, B, Ochir, C, Odukoya, O, Oh, I, Olagunju, A, Olakunde, B, Omar Bali, A, Omer, E, Otstavnov, S, Oumer, B, Padubidri, J, Pana, A, Pandey, A, Park, E, Pashazadeh Kan, F, Patel, U, Paudel, U, Petcu, I, Piracha, Z, Pollok, R, Postma, M, Pourshams, A, Poustchi, H, Rabiee, M, Rabiee, N, Rafiei, A, Rafiei, S, Raghuram, P, Rahman, M, Rahmani, A, Rahmawaty, S, Rajesh, A, Ranasinghe, P, Rao, C, Rao, S, Rashidi, M, Rawaf, D, Rawaf, S, Rawassizadeh, R, Rezaei, N, Rezapour, A, Rezazadeh-Khadem, S, Rodriguez, J, Rwegerera, G, Sabour, S, Saddik, B, Saeb, M, Saeed, U, Sahebkar, A, Saif-Ur-Rahman, K, Salahi, S, Salimzadeh, H, Sampath, C, Samy, A, Sanabria, J, Sanmarchi, F, Santric-Milicevic, M, Sarveazad, A, Sathian, B, Sawhney, M, Seidu, A, Sepanlou, S, Seylani, A, Shahabi, S, Shaikh, M, Shaker, E, Shakhmardanov, M, Shannawaz, M, Shenoy, S, Shetty, J, Shetty, P, Shibuya, K, Shin, J, Shobeiri, P, Sibhat, M, Singh, A, Singh, J, Singh, S, Skryabin, V, Skryabina, A, Sohrabpour, A, Song, S, Tabaeian, S, Tadesse, E, Taheri, M, Tampa, M, Tan, K, Tavakoli, A, Tbakhi, A, Tefera, B, Tehrani-Banihashemi, A, Tesfaw, H, Thapar, R, Thavamani, A, Tohidast, S, Tollosa, D, Tosti, M, Tovani-Palone, M, Traini, E, Tran, M, Trihandini, I, Tusa, B, Ullah, I, Vacante, M, Valadan Tahbaz, S, Valdez, P, Varthya, S, Vo, B, Waheed, Y, Weldesenbet, A, Woldemariam, M, Xu, S, Yahyazadeh Jabbari, S, Yaseri, M, Yeshaw, Y, Yigit, V, Yirdaw, B, Yonemoto, N, Yu, C, Yunusa, I, Zahir, M, Zaki, L, Zamani, M, Zamanian, M, Zastrozhin, M, Vos, T, Ward, J, Dirac, M, Sheena B. 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Abstract

Background: Combating viral hepatitis is part of the UN Sustainable Development Goals (SDGs), and WHO has put forth hepatitis B elimination targets in its Global Health Sector Strategy on Viral Hepatitis (WHO-GHSS) and Interim Guidance for Country Validation of Viral Hepatitis Elimination (WHO Interim Guidance). We estimated the global, regional, and national prevalence of hepatitis B virus (HBV), as well as mortality and disability-adjusted life-years (DALYs) due to HBV, as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. This included estimates for 194 WHO member states, for which we compared our estimates to WHO elimination targets. Methods: The primary data sources were population-based serosurveys, claims and hospital discharges, cancer registries, vital registration systems, and published case series. We estimated chronic HBV infection and the burden of HBV-related diseases, defined as an aggregate of cirrhosis due to hepatitis B, liver cancer due to hepatitis B, and acute hepatitis B. We used DisMod-MR 2.1, a Bayesian mixed-effects meta-regression tool, to estimate the prevalence of chronic HBV infection, cirrhosis, and aetiological proportions of cirrhosis. We used mortality-to-incidence ratios modelled with spatiotemporal Gaussian process regression to estimate the incidence of liver cancer. We used the Cause of Death Ensemble modelling (CODEm) model, a tool that selects models and covariates on the basis of out-of-sample performance, to estimate mortality due to cirrhosis, liver cancer, and acute hepatitis B. Findings: In 2019, the estimated global, all-age prevalence of chronic HBV infection was 4·1% (95% uncertainty interval [UI] 3·7 to 4·5), corresponding to 316 million (284 to 351) infected people. There was a 31·3% (29·0 to 33·9) decline in all-age prevalence between 1990 and 2019, with a more marked decline of 76·8% (76·2 to 77·5) in prevalence in children younger than 5 years. HBV-related diseases resulted in 555 0

Published
2022

2. Global, regional, and national burden of hepatitis B, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Author

Brittney S Sheena, Lindsey Hiebert, Hannah Han, Helen Ippolito, Mohsen Abbasi-Kangevari, Zeinab Abbasi-Kangevari, Hedayat Abbastabar, Amir Abdoli, Hiwa Abubaker Ali, Mesafint Molla Adane, Oyelola A Adegboye, Qorinah Estiningtyas Sakilah Adnani, Shailesh M Advani, Muhammad Sohail Afzal, Saira Afzal, Mohamad Aghaie Meybodi, Bahman Ahadinezhad, Bright Opoku Ahinkorah, Sajjad Ahmad, Tauseef Ahmad, Sepideh Ahmadi, Haroon Ahmed, Muktar Beshir Ahmed, Tarik Ahmed Rashid, Gizachew Taddesse Akalu, Addis Aklilu, Tayyaba Akram, Hanadi Al Hamad, Fares Alahdab, Adugnaw Zeleke Alem, Dejene Tsegaye Alem, Fadwa Alhalaiqa Naji Alhalaiqa, Robert Kaba Alhassan, Liaqat Ali, Muhammad Ashar Ali, Yousef Alimohamadi, Vahid Alipour, Motasem Alkhayyat, Sami Almustanyir, Rajaa M Al-Raddadi, Haya Altawalah, Saeed Amini, Hubert Amu, Robert Ancuceanu, Catalina Liliana Andrei, Tudorel Andrei, Amir Anoushiravani, Adnan Ansar, Anayochukwu Edward Anyasodor, Jalal Arabloo, Morteza Arab-Zozani, Ayele Mamo Argaw, Zeleke Gebru Argaw, Muhammad Arshad, Anton A Artamonov, Tahira Ashraf, Daniel Atlaw, Floriane Ausloos, Marcel Ausloos, Sina Azadnajafabad, Mohammadreza Azangou-Khyavy, Amirhossein Azari Jafari, Ghasem Azarian, Sayna Bagheri, Saeed Bahadory, Atif Amin Baig, Maciej Banach, Nastaran Barati, Amadou Barrow, Abdul-Monim Mohammad Batiha, Diana Fernanda Bejarano Ramirez, Uzma Iqbal Belgaumi, Alemshet Yirga Berhie, Devidas S Bhagat, Nikha Bhardwaj, Pankaj Bhardwaj, Krittika Bhattacharyya, Vijayalakshmi S Bhojaraja, Ali Bijani, Antonio Biondi, Belay Boda Abule Bodicha, Hunduma Amensisa Bojia, Archith Boloor, Cristina Bosetti, Dejana Braithwaite, Nikolay Ivanovich Briko, Zahid A Butt, Luis Alberto Cámera, Raja Chandra Chakinala, Promit Ananyo Chakraborty, Jaykaran Charan, Shu Chen, Jee-Young Jasmine Choi, Sonali Gajanan Choudhari, Fazle Rabbi Chowdhury, Dinh-Toi Chu, Sheng-Chia Chung, Paolo Angelo Cortesi, Benjamin C Cowie, Garland T Culbreth, Omid Dadras, Xiaochen Dai, Lalit Dandona, Rakhi Dandona, Fernando Pio De la Hoz, Sisay Abebe Debela, Mohammed Gebre Dedefo, Feleke Mekonnen Demeke, Takele Gezahegn G Demie, Getu Debalkie Demissie, Meseret Derbew Molla, Abebaw Alemayehu Desta, Deepak Dhamnetiya, Mandira Lamichhane Dhimal, Meghnath Dhimal, Mojtaba Didehdar, Linh Phuong Doan, Fariba Dorostkar, Thomas M Drake, Fatemeh Eghbalian, Michael Ekholuenetale, Iman El Sayed, Maysaa El Sayed Zaki, Muhammed Elhadi, Mohamed A Elmonem, Aisha Elsharkawy, Shymaa Enany, Daniel Berhanie Enyew, Ryenchindorj Erkhembayar, Sharareh Eskandarieh, Firooz Esmaeilzadeh, Sayeh Ezzikouri, Hossein Farrokhpour, Getahun Fetensa, Florian Fischer, Masoud Foroutan, Mohamed M Gad, Abhay Motiramji Gaidhane, Shilpa Gaidhane, Natalie C Galles, Silvano Gallus, Teferi Gebru Gebremeskel, Eyob Alemayehu Gebreyohannes, Keyghobad Ghadiri, Kazem Ghaffari, Mansour Ghafourifard, Seyyed-Hadi Ghamari, Ahmad Ghashghaee, Ali Gholami, Abdolmajid Gholizadeh, Aima Gilani, Amit Goel, Mahaveer Golechha, Pouya Goleij, Davide 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Subjects
Liver Cirrhosis, Hepatology, Seroepidemiologic Studies, 3121 General medicine, internal medicine and other clinical medicine, Liver Neoplasms, Gastroenterology, Humans, Bayes Theorem, HBV, Global burden of diseases, HCC, Cirrhosis, Child, Hepatitis B, Global Burden of Disease
Abstract

Publisher Copyright: © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Background: Combating viral hepatitis is part of the UN Sustainable Development Goals (SDGs), and WHO has put forth hepatitis B elimination targets in its Global Health Sector Strategy on Viral Hepatitis (WHO-GHSS) and Interim Guidance for Country Validation of Viral Hepatitis Elimination (WHO Interim Guidance). We estimated the global, regional, and national prevalence of hepatitis B virus (HBV), as well as mortality and disability-adjusted life-years (DALYs) due to HBV, as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. This included estimates for 194 WHO member states, for which we compared our estimates to WHO elimination targets. Methods: The primary data sources were population-based serosurveys, claims and hospital discharges, cancer registries, vital registration systems, and published case series. We estimated chronic HBV infection and the burden of HBV-related diseases, defined as an aggregate of cirrhosis due to hepatitis B, liver cancer due to hepatitis B, and acute hepatitis B. We used DisMod-MR 2.1, a Bayesian mixed-effects meta-regression tool, to estimate the prevalence of chronic HBV infection, cirrhosis, and aetiological proportions of cirrhosis. We used mortality-to-incidence ratios modelled with spatiotemporal Gaussian process regression to estimate the incidence of liver cancer. We used the Cause of Death Ensemble modelling (CODEm) model, a tool that selects models and covariates on the basis of out-of-sample performance, to estimate mortality due to cirrhosis, liver cancer, and acute hepatitis B. Findings: In 2019, the estimated global, all-age prevalence of chronic HBV infection was 4·1% (95% uncertainty interval [UI] 3·7 to 4·5), corresponding to 316 million (284 to 351) infected people. There was a 31·3% (29·0 to 33·9) decline in all-age prevalence between 1990 and 2019, with a more marked decline of 76·8% (76·2 to 77·5) in prevalence in children younger than 5 years. HBV-related diseases resulted in 555 000 global deaths (487 000 to 630 000) in 2019. The number of HBV-related deaths increased between 1990 and 2019 (by 5·9% [–5·6 to 19·2]) and between 2015 and 2019 (by 2·9% [–5·9 to 11·3]). By contrast, all-age and age-standardised death rates due to HBV-related diseases decreased during these periods. We compared estimates for 2019 in 194 WHO locations to WHO-GHSS 2020 targets, and found that four countries achieved a 10% reduction in deaths, 15 countries achieved a 30% reduction in new cases, and 147 countries achieved a 1% prevalence in children younger than 5 years. As of 2019, 68 of 194 countries had already achieved the 2030 target proposed in WHO Interim Guidance of an all-age HBV-related death rate of four per 100 000. Interpretation: The prevalence of chronic HBV infection declined over time, particularly in children younger than 5 years, since the introduction of hepatitis B vaccination. HBV-related death rates also decreased, but HBV-related death counts increased as a result of population growth, ageing, and cohort effects. By 2019, many countries had met the interim seroprevalence target for children younger than 5 years, but few countries had met the WHO-GHSS interim targets for deaths and new cases. Progress according to all indicators must be accelerated to meet 2030 targets, and there are marked disparities in burden and progress across the world. HBV interventions, such as vaccination, testing, and treatment, must be strategically supported and scaled up to achieve elimination. Funding: Bill & Melinda Gates Foundation.

Published
2022

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