{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T07:58:07Z","timestamp":1790582287477,"version":"4.1.0"},"reference-count":21,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Viral Hepatitis"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Viral hepatitis mortality is an impact target required to evidence the elimination of viral hepatitis with a combined mortality rate of less than or equal to six deaths per 100,000 population. Within England, routine healthcare data linked with death registrations are used; however, where these data are not available, the World Health Organization (WHO) recommends overlaying the attributable fraction (AF) over the mortality envelope for decompensated cirrhosis (DC) and hepatocellular carcinoma (HCC). We aimed to estimate viral hepatitis mortality using the attributable fraction and compared it to surveillance methods. Six acute NHS trusts participated across England and reviewed the case records of individuals identified retrospectively up to 31 December 2023 through hospital episode statistics to confirm the diagnosis and complete a proforma on possible exposures and likely cause of DC\/HCC. Overall, 563 individuals were identified, 390 for DC review with 127 (32.6%) confirmed and 173 for HCC review with 157 (91.8%) confirmed. The AF for DC was 0.008 for HCV and 0.016 for HBV, equivalent to a crude mortality rate of 0.09 per 100,000 population and 0.17 per 100,000 population, respectively. For HCC 0.1806 for HCV and 0.0645 for HBV, equivalent to 0.85 per 100,000 population and 0.30 per 100,000 population respectively. These results are comparable to applying the attributable fraction methodology to linking healthcare data sets and demonstrate that England continues to meet the WHO impact target.<\/jats:p>","DOI":"10.1111\/jvh.70228","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T06:59:22Z","timestamp":1790060362000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Estimating the Fraction of Hepatocellular Carcinoma and Decompensated Cirrhosis Attributable to Viral Hepatitis in England Using Electronic Health Records and Case\u2010Notes Review"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2807-6272","authenticated-orcid":false,"given":"David","family":"Etoori","sequence":"first","affiliation":[{"name":"Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME) Institute for Global Health, University College London  UK"},{"name":"National Institute for Health and Care Research (NIHR) Health Protection Research Unit (HPRU) in Blood\u2010Borne and Sexually Transmitted Infections at UCL in Partnership With the UK Health Security Agency (UKHSA)  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0679-2136","authenticated-orcid":false,"given":"Annabel","family":"Powell","sequence":"additional","affiliation":[{"name":"Blood Safety, Hepatitis, Sexually Transmitted Infections and HIV Division UK Health Security Agency  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5016-4607","authenticated-orcid":false,"given":"Paul","family":"Trembling","sequence":"additional","affiliation":[{"name":"Division of Medicine, Institute for Liver and Digestive Health University College London, Royal Free Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1398-9683","authenticated-orcid":false,"given":"Jennifer","family":"Plunkett","sequence":"additional","affiliation":[{"name":"Division of Medicine, Institute for Liver and Digestive Health University College London, Royal Free Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Brown","sequence":"additional","affiliation":[{"name":"Imperial College Healthcare NHS Trust St Mary's Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9011-2991","authenticated-orcid":false,"given":"Maud","family":"Lemoine","sequence":"additional","affiliation":[{"name":"Imperial College Healthcare NHS Trust St Mary's Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9649-4444","authenticated-orcid":false,"given":"Stephen","family":"Ryder","sequence":"additional","affiliation":[{"name":"Nottingham University Hospitals NHS Trust  Nottingham UK"},{"name":"NIHR Nottingham Biomedical Research Centre at Nottingham University Hospitals NHS Trust  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Montague","sequence":"additional","affiliation":[{"name":"Nottingham University Hospitals NHS Trust  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleanor","family":"Pilsworth","sequence":"additional","affiliation":[{"name":"Sheffield Teaching Hospitals NHS Foundation Trust  Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Bains","sequence":"additional","affiliation":[{"name":"Sheffield Teaching Hospitals NHS Foundation Trust  Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5516-4764","authenticated-orcid":false,"given":"Laura","family":"Harrison","sequence":"additional","affiliation":[{"name":"Sheffield Teaching Hospitals NHS Foundation Trust  Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9882-8874","authenticated-orcid":false,"given":"Michael","family":"Pavlides","sequence":"additional","affiliation":[{"name":"NIHR Biomedical Research Centre Oxford University Hospitals NHS Foundation Trust and University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5369-3734","authenticated-orcid":false,"given":"Ahmed","family":"Elsharkawy","sequence":"additional","affiliation":[{"name":"NIHR Biomedical Research Centre at University Hospitals Birmingham NHS Foundation Trust and University of Birmingham  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5173-2760","authenticated-orcid":false,"given":"Caroline","family":"Sabin","sequence":"additional","affiliation":[{"name":"Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME) Institute for Global Health, University College London  UK"},{"name":"National Institute for Health and Care Research (NIHR) Health Protection Research Unit (HPRU) in Blood\u2010Borne and Sexually Transmitted Infections at UCL in Partnership With the UK Health Security Agency (UKHSA)  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Desai","sequence":"additional","affiliation":[{"name":"Blood Safety, Hepatitis, Sexually Transmitted Infections and HIV Division UK Health Security Agency  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8156-0146","authenticated-orcid":false,"given":"Ruth","family":"Simmons","sequence":"additional","affiliation":[{"name":"National Institute for Health and Care Research (NIHR) Health Protection Research Unit (HPRU) in Blood\u2010Borne and Sexually Transmitted Infections at UCL in Partnership With the UK Health Security Agency (UKHSA)  London UK"},{"name":"Blood Safety, Hepatitis, Sexually Transmitted Infections and HIV Division UK Health Security Agency  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"World Health Organization \u201cGlobal Hepatitis Report 2026 \u201d(2026) https:\/\/iris.who.int\/server\/api\/core\/bitstreams\/6f6caedc\u201037a0\u201049ee\u2010a02a\u2010df9c3b78ff42\/content."},{"key":"e_1_2_10_3_1","doi-asserted-by":"crossref","unstructured":"M.Cao F.Wei D.Georges C. J.Alberts G. M.Clifford andC.deMartel \u201cHepatocellular Carcinoma Attributable to Hepatitis B Hepatitis C and Other Risk Factors at Global Regional and National Levels: An Updated Systematic Review and Meta\u2010Analysis \u201dGut (2026): gutjnl\u20102025\u2010337838.","DOI":"10.1136\/gutjnl-2025-337838"},{"key":"e_1_2_10_4_1","unstructured":"UK Health Security Agency \u201cHepatitis C in England 2025 \u201d(2026) https:\/\/www.gov.uk\/government\/publications\/hepatitis\u2010c\u2010in\u2010england\u2010and\u2010the\u2010uk\/hepatitis\u2010c\u2010in\u2010england\u20102025#reducing\u2010prevalence\u2010and\u2010incidence\u2010of\u2010hepatitis\u2010c\u2010virus\u2010infection."},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/jvh.70016"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/jvh.13096"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jvh.12803"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.2196\/publichealth.7370"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu077"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.31280"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/jvh.13545"},{"key":"e_1_2_10_12_1","unstructured":"World Health Organisation \u201cConsolidated Strategic Information Guidelines for Viral Hepatitis Planning and Tracking Progress Towards Elimination: Guidelines; Web Annex 3 \u201d(2019) Protocol for surveillance of the fraction of cirrhosis and hepatocellular carcinoma attributable to viral hepatitis in clinical centres of excellence https:\/\/iris.who.int\/server\/api\/core\/bitstreams\/c3140d34\u2010b6a4\u20104b2a\u20109107\u2010147c038b6a3e\/content."},{"key":"e_1_2_10_13_1","unstructured":"Pan American Health Organisation \u201cProtocol to Estimate Mortality From Cirrhosis and Hepatocellular Carcinoma Attributable to Viral Hepatitis B and C \u201d(2021) https:\/\/iris.paho.org\/server\/api\/core\/bitstreams\/ef9ddb42\u2010ab03\u20104ff0\u20108ea0\u2010ef8c982c332b\/content."},{"key":"e_1_2_10_14_1","unstructured":"World Health Organisation \u201cWeb Annex 3 \u201d(2019) Protocol for Surveillance of the Fraction of Cirrhosis and Hepatocellular Carcinoma Attributable to Viral Hepatitis in Clinical Centres of Excellence."},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/jvh.13063"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.32341"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2024.08.028"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12876-022-02198-w"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.3390\/clinpract14060200"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-021-07282-x"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-023-07876-7"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28535"}],"container-title":["Journal of Viral Hepatitis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jvh.70228","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jvh.70228","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jvh.70228","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T07:42:35Z","timestamp":1790581355000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jvh.70228"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,21]]},"references-count":21,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/jvh.70228"],"URL":"https:\/\/doi.org\/10.1111\/jvh.70228","archive":["Portico"],"relation":{},"ISSN":["1352-0504","1365-2893"],"issn-type":[{"value":"1352-0504","type":"print"},{"value":"1365-2893","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,21]]},"assertion":[{"value":"2026-06-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70228"}}