Mortality Attributable to Hepatitis B and C in Italy, Romania, and Spain, 2022 Estimates

BACKGROUND AND AIMS: Reliable data on viral hepatitis-related deaths remain limited, challenging assessment of progress towards the WHO elimination targets for mortality. To address this gap, we estimated hepatitis B- and C-attributable mortality in Italy, Romania, and Spain for 2022. METHODS: Retrospective hospital data on decompensated cirrhosis and hepatocellular carcinoma cases were collected from sentinel sites in each of three countries using standard WHO protocol. The data were used to calculate fractions of these diseases attributable to hepatitis B and C. Adjusted and weighted attributable fractions were applied to national vital statistics data on deaths from cirrhosis and hepatocellular carcinoma from Eurostat to produce national hepatitis mortality estimates. RESULTS: A total of 1733 cases of decompensated cirrhosis and hepatocellular carcinoma cases were enrolled into the study from sentinel sites across Italy, Romania, and Spain. We estimated that the share of decompensated cirrhosis deaths attributed to hepatitis B was: 8.7% in Italy, 16.8% in Romania and 1.8% in Spain. The respective share of hepatocellular carcinoma deaths attributed to hepatitis B was 19.0% in Italy, 31.2% in Romania and 4.9% in Spain. Hepatitis C accounted for 61.6% of hepatocellular carcinoma deaths in Italy, 36.5% in Romania, and 31.1% in Spain, as well as 32.9% of decompensated cirrhosis deaths in Italy, 18.8% in Romania and 12.7% in Spain. Overall, hepatitis B-related mortality per 100 000 population was 3.1 in Italy, 12.0 in Romania and 0.6 in Spain. Hepatitis C-related mortality was 11.4 per 100 000 population in Italy, 13.8 in Romania and 3.7 in Spain. CONCLUSIONS: Our study yielded empirical data needed to estimate hepatitis mortality for assessing the impact of hepatitis strategies. Whilst our results indicate a reduction in deaths related to hepatitis B and C in Italy and Spain, none of the three countries was meeting the WHO's 2025 target for hepatitis C-related mortality, although the hepatitis B-related mortality target was met by Italy and Spain. Our findings highlight the need for countries to continue strengthening efforts to prevent and control viral hepatitis and to integrate such assessments into national surveillance to guide effective targeting of interventions and monitoring of progress towards the elimination targets.

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Publication Details

Journal
Liver International
Published
2026-06-19
DOI
https://doi.org/10.1111/liv.70753
Primary Topic
Hepatitis B Virus Studies
Type
article
Field-Weighted Citation Impact
0.00

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article

Mortality Attributable to Hepatitis B and C in Italy, Romania, and Spain, 2022 Estimates

Răzvan Cerban, Maria Giovanna Quaranta, María Buti Ferret, Loreta Anesti Kondili et al.
Liver International
Hepatitis B Virus Studies
article

Mortality Attributable to Hepatitis B and C in Italy, Romania, and Spain, 2022 Estimates

Răzvan Cerban, Maria Giovanna Quaranta, María Buti Ferret, Loreta Anesti Kondili, Alessandro Loglio, Simona Albano, Vincenza Calvaruso, A J Julieta Díaz, Ciro Celsa, Maria Rendina, Denisa Janţă, Mirela Chitul, Roberta Coppola, Otilia Mårdh, Jürgen K. Rockstroh, Sara Battistella, Benedetta Mattioli, Odette Popovici, Catalina Fernández Méndez, Oleksandr Korotych, Roxana Șirli, Gaetano Marrone, Stefano Rosato, Maurizia Rossana Brunetto, Catherine de Martel, Laura Huiban, Valentina Cossiga, Cristian Calomfirescu, S. Fagiuoli, Dorthe Raben, Anca Victorita Trifan, Caterina Sagnelli, Marie-Louise Jakobsen, Carmen Ester, Camelia Nica, Helene Høgsbro Thygesen, Sonia Alonso, Luis Morano, Elena Vargas-Accarino, Adriana Ahumada, Barbara Coco, Antonella De Feudis, Cristina Muzica, Erika Duffell, Nicola Coppola, Alexandru Popa, Mihaela Ghioca, M Viganò, L Gheorghe, Juliana Reyes‐Urueña, Filomena Morisco, Alina Popescu, Francesco Longobardi, Francesco Paolo Russo, Rafael Bañares Cañizares
article en

Abstract

BACKGROUND AND AIMS: Reliable data on viral hepatitis-related deaths remain limited, challenging assessment of progress towards the WHO elimination targets for mortality. To address this gap, we estimated hepatitis B- and C-attributable mortality in Italy, Romania, and Spain for 2022. METHODS: Retrospective hospital data on decompensated cirrhosis and hepatocellular carcinoma cases were collected from sentinel sites in each of three countries using standard WHO protocol. The data were used to calculate fractions of these diseases attributable to hepatitis B and C. Adjusted and weighted attributable fractions were applied to national vital statistics data on deaths from cirrhosis and hepatocellular carcinoma from Eurostat to produce national hepatitis mortality estimates. RESULTS: A total of 1733 cases of decompensated cirrhosis and hepatocellular carcinoma cases were enrolled into the study from sentinel sites across Italy, Romania, and Spain. We estimated that the share of decompensated cirrhosis deaths attributed to hepatitis B was: 8.7% in Italy, 16.8% in Romania and 1.8% in Spain. The respective share of hepatocellular carcinoma deaths attributed to hepatitis B was 19.0% in Italy, 31.2% in Romania and 4.9% in Spain. Hepatitis C accounted for 61.6% of hepatocellular carcinoma deaths in Italy, 36.5% in Romania, and 31.1% in Spain, as well as 32.9% of decompensated cirrhosis deaths in Italy, 18.8% in Romania and 12.7% in Spain. Overall, hepatitis B-related mortality per 100 000 population was 3.1 in Italy, 12.0 in Romania and 0.6 in Spain. Hepatitis C-related mortality was 11.4 per 100 000 population in Italy, 13.8 in Romania and 3.7 in Spain. CONCLUSIONS: Our study yielded empirical data needed to estimate hepatitis mortality for assessing the impact of hepatitis strategies. Whilst our results indicate a reduction in deaths related to hepatitis B and C in Italy and Spain, none of the three countries was meeting the WHO's 2025 target for hepatitis C-related mortality, although the hepatitis B-related mortality target was met by Italy and Spain. Our findings highlight the need for countries to continue strengthening efforts to prevent and control viral hepatitis and to integrate such assessments into national surveillance to guide effective targeting of interventions and monitoring of progress towards the elimination targets.

Liver InternationalVol. 46(7)
University of Pisa (IT), Hebron University (PS), Universitat Autònoma de Barcelona (ES), University of Bonn (DE), University of Padua (IT), Istituto Superiore di Sanità (IT), University Hospital Bonn (DE), Instituto de Salud Carlos III (ES), Regione Campania (IT), University Hospital Complex Of Vigo (ES), Hospital General Universitario Gregorio Marañón (ES), West University of Timişoara (RO), Institutul Regional de Oncologie (RO), Spitalul Clinic Judeţean de Urgenţă "Pius Brînzeu" Timişoara (RO), Spitalul Clinic C.F. Iasi (RO), Azienda Universitaria Ospedaliera Consorziale - Policlinico Bari (IT), Saint Camillus International University of Health and Medical Sciences (IT), Vall d'Hebron Institut de Recerca (ES), World Health Organization (CH), Ospedale Papa Giovanni XXIII (IT), Department of Health (ES), Federico II University Hospital (IT), Dr. Lisbeth Hurni Coaching & Consulting (CH), Clinica de Pneumologie Iaşi (RO), Vall d'Hebron Hospital Universitari (ES), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (ES), Institute e-Austria Timisoara (RO), Centre of Excellence for Health, Immunity and Infections (DK), Institutul Clinic Fundeni (RO), National School of Public Health, Management and Professional Development (RO), Azienda Ospedaliera Universitaria Pisana (IT), University of Bari Aldo Moro (IT), European Centre for Disease Prevention and Control (SE), University of Naples Federico II (IT)
European Centre for Disease Prevention and Control, Rigshospitalet
Good health and well-being
Openalex Percentile: Top 7%
Hepatitis B Virus Studies
DOISourceOpenAlex
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