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Health Sciences › Medicine › Epidemiology
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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Paper Summary
Conflicts of Interest
Identified Weaknesses
Rating Explanation
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Paper Summary
Paperzilla title
HBV is declining, but is it declining fast enough? A global check-up.
Global chronic HBV prevalence has declined significantly, particularly in children under 5, largely due to vaccination efforts. However, HBV-related deaths are increasing in many countries due to population growth and aging, necessitating accelerated efforts to diagnose and treat existing infections.
Possible Conflicts of Interest
Funding from the Bill & Melinda Gates Foundation. Several authors report grants, consulting fees, royalties, stock options, and other potential conflicts related to pharmaceutical companies and other organizations.
Identified Weaknesses
Limitations in Modeling Vaccination Trends
The study relies on a post-hoc adjustment to incorporate vaccination trends due to limitations in the DisMod-MR 2.1 model, which might not accurately reflect the rapid changes in HBsAg seroprevalence and could lead to overestimation.
Assumption of Similar Progression Rates Across Aetiologies
The study uses aetiological proportions for cirrhosis and liver cancer from case series to divide both prevalence and mortality parent estimates, assuming similar progression rates across aetiologies, which might not be accurate.
Data Sparsity in Models
Data sparsity exists in several models, particularly for cirrhosis and liver cancer aetiological proportions, leading to reliance on predictive covariates and potentially less accurate estimates for data-sparse locations.
Missing Covariates
The study does not include coverage of suppressive antiviral therapy or prevalence of HDV infection among HBV-infected individuals as covariates, which could affect estimates, as these factors can influence disease progression.
Limited Information on Interventions
The analysis is limited by the GBD's framework, which does not provide detailed information on specific interventions and their effectiveness.
Rating Explanation
This is a large-scale, comprehensive study with valuable findings. While limitations exist concerning modeling vaccination and disease progression, as well as data sparsity, the methodological framework is strong overall and the limitations are acknowledged by the authors. The study uses a variety of data sources and sophisticated statistical techniques to address an important global health issue and the findings are useful for guiding policy and interventions.
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Topic Hierarchy
File Information
Original Title:
Global, regional, and national burden of hepatitis B, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019
File Name:
GBD_LGH_Global_Regional_And_VOR.pdf
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File Size:
6.30 MB
Uploaded:
July 14, 2025 at 06:48 AM
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