Wednesday, October 9, 2013

As many as 80,000 people with hepatitis C virus (HCV) infection could die yearly in the United States

CDC Figures Annual US Mortality in People With HCV Could Top 80,000: HCV Mortality Under-reported, Mortality Rate 12 Times Higher than General Population, HCV+ Die 15 Years Younger than General Population

ID Week, October 2-6, 2013, San Francisco

The annual ID Week meeting featured the latest research and approaches to prevention, diagnosis, treatment, and epidemiology of infectious diseases.

Jules Levin the founder and executive director of NATAP continues to report on the conference providing commentary, abstracts, slides and reports, available here.

This study with an article written Mark Mascolini examined liver-related mortality in people infected with HCV living in the U.S. The investigators calculated death rates based on US census data from 2006-2010 and 12 million death certificates for residents during the same time period. The researchers concluded that 80% of death certificates did not list HCV as cause of death. Only 15,000 deaths were listed on the death certificate as having HCV infection, Mark Mascolini explains.....

By Mark Mascolini 
As many as 80,000 people with hepatitis C virus (HCV) infection could die yearly in the United States, according to results of a multicohort analysis from 2006 through 2010 [1]. People with HCV died at an average age 15 years younger than people in the general population. 
From 2.7 to 3.9 million people in the United States have chronic HCV infection. To estimate all-cause and liver-related mortality among HCV-positive US residents, the Centers for Disease Control and Prevention (CDC) examined electronic medical records of adults who had at least one health system encounter from January 2006 through December 2010 in four integrated healthcare systems. In the resulting Chronic Hepatitis Cohort Study (CHeCS), the investigators identified those who died from 2006 through 2010. They compared CHeCS mortality findings with data from the national Multiple Cause of Death (MCOD) study in the same period.

From 2006 through 2010, the CDC team considered 11,703 people with chronic HCV representing 0.5% of patients in the 2.1-million person CHeCS cohort. Among people with HCV, 1590 (14%) died during the study period. Most people who died were 45 to 59 years old (60%), followed by the group 60 and older (34%). Men accounted for two thirds of the deaths (68%), whites for 50%, and blacks for 35%. Almost three quarters of those who died (72%) had a median household income between $15,000 and $50,000, while 25% had a higher income.

Compared with MCOD data, mortality was 12 times higher in CHeCS. Age-adjusted mortality in CHeCS compared with MCOD was 61 times higher for HCV infection (relative risk [RR] 61.4), 29 times higher for liver cancer (RR 28.8), 24 times higher for nonalcohol-related liver disease (RR 24.4), 10 times higher for HIV infection (RR 9.8), 6 times higher for alcohol-related liver disease (RR 6.2), and 86 times higher for unspecified hepatitis-related disease (RR 86.1) (P < 0.0001 for all).

Age averaged 59 years in CHeCS members who died, 15 years younger than the all-cause death age in US national data.

Among the 1590 CHeCS members who died, only 306 (19%) had HCV infection listed as an underlying cause on their death certificate. Among people who died of liver cancer, only 32% had HCV listed as an underlying cause. Death certificates did not list HCV for most deaths regardless of whether the deaths were liver-related or not. Among CHeCS members who died, medical records (ICD-9 codes) noted liver disease in 63%, and FIB-4 scores indicated liver disease in 76%.

"Even in these well-characterized HCV patients," the CDC team concluded, "HCV was noted in only 19% of death certificates." Based on this finding, the researchers estimated that more than 80,000 US residents with HCV died in 2010. They noted that chronic liver disease recorded in two thirds of CHeCS members who died "suggests that 53,000 patients are dying not only with, but possibly from HCV."
Continue Reading - View Abstract and Slides here

Conference Coverage At Healio

Healio reports on the increase of  all-cause mortality in persons living with HCV. The video provided below describes the risk for extrahepatic manifestations and other medical problems in HCV rather the disease is mild or advanced such as heart disease, diabetes, cancers but not just liver cancer - lung and endocrine malignancies.

Identification of hepatitis C crucial in addressing disease
SAN FRANCISCO — Eliot Godofsky, MD, director of the University Hepatitis Center in Sarasota, Fla., discusses strategies to improve the identification of hepatitis C patients. Up to 70% of people with hepatitis C are unaware of their infection status, many of whom were born between 1945 and 1965.

ID Week, October 2-6, 2013, San Francisco

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