TY - JOUR

T1 - Increased mortality among persons infected with hepatitis C virus

AU - Omland, Lars Haukali Hvass

AU - Jepsen, Peter

AU - Krarup, Henrik

AU - Schønning, Kristian

AU - Lind, Bent

AU - Kromann-Andersen, Hans

AU - Homburg, Keld Mikkelsen

AU - Christensen, Peer Brehm

AU - Sørensen, Henrik Toft

AU - Obel, Niels

AU - Bangsborg, Jette Marie

AU - DANVIR Cohort Study

N1 - Copyright © 2011 AGA Institute. Published by Elsevier Inc. All rights reserved.

PY - 2011/1/1

Y1 - 2011/1/1

N2 - Background & Aims The long-term mortality of patients infected with hepatitis C virus (HCV) is not known; few studies have controlled for potential confounders, investigated how mortality changes with age at diagnosis and length of follow-up period, provided absolute risk estimates of death, or analyzed specific causes of death. Methods Using a Danish population, we compared mortality of a cohort of 10,991 HCV-infected patients with that of an age- and sex-matched cohort. Using regression analysis, we adjusted for municipality of residence, history of psychiatric illness, comorbidities, alcohol and drug abuse, and income. We analyzed causes of death and effects of HCV with age and length of follow-up period. Results HCV-infected patients had lower income levels and more comorbidities, psychiatric illnesses, and substance and alcohol abuse than the comparison cohort. The 10-year survival rate decreased from 84.1% among HCV-infected patients aged 20 to 29 years to 21.1% among those aged 70 years or older. The increased risk of death among HCV-infected patients was more pronounced in the first year of follow-up period than in subsequent years and in the unadjusted than in the adjusted analysis. Starting in the second year of the follow-up period, HCV-infected patients aged 20 to 29 years had an 18.2-fold increased risk of death, whereas those that were 70 years or older had a 1.6-fold increased risk. Most deaths among younger patients were from unnatural causes, and most deaths among patients 70 years or older were from non–liver-related natural causes. Conclusions HCV infection is associated with increased mortality; younger patients (age, 20–29 y) have an increased risk of unnatural death.

AB - Background & Aims The long-term mortality of patients infected with hepatitis C virus (HCV) is not known; few studies have controlled for potential confounders, investigated how mortality changes with age at diagnosis and length of follow-up period, provided absolute risk estimates of death, or analyzed specific causes of death. Methods Using a Danish population, we compared mortality of a cohort of 10,991 HCV-infected patients with that of an age- and sex-matched cohort. Using regression analysis, we adjusted for municipality of residence, history of psychiatric illness, comorbidities, alcohol and drug abuse, and income. We analyzed causes of death and effects of HCV with age and length of follow-up period. Results HCV-infected patients had lower income levels and more comorbidities, psychiatric illnesses, and substance and alcohol abuse than the comparison cohort. The 10-year survival rate decreased from 84.1% among HCV-infected patients aged 20 to 29 years to 21.1% among those aged 70 years or older. The increased risk of death among HCV-infected patients was more pronounced in the first year of follow-up period than in subsequent years and in the unadjusted than in the adjusted analysis. Starting in the second year of the follow-up period, HCV-infected patients aged 20 to 29 years had an 18.2-fold increased risk of death, whereas those that were 70 years or older had a 1.6-fold increased risk. Most deaths among younger patients were from unnatural causes, and most deaths among patients 70 years or older were from non–liver-related natural causes. Conclusions HCV infection is associated with increased mortality; younger patients (age, 20–29 y) have an increased risk of unnatural death.

KW - Adult

KW - Case-Control Studies

KW - Cohort Studies

KW - Denmark

KW - Female

KW - Hepacivirus

KW - Hepatitis C

KW - Humans

KW - Male

KW - Middle Aged

KW - Risk Factors

U2 - 10.1016/j.cgh.2010.09.014

DO - 10.1016/j.cgh.2010.09.014

M3 - Journal article

C2 - 20888437

VL - 9

SP - 71

EP - 78

JO - Clinical Gastroenterology and Hepatology

JF - Clinical Gastroenterology and Hepatology

SN - 1542-3565

IS - 1

ER -