Increased all-cause, liver, and cardiac mortality among hepatitis C virus-seropositive blood donors

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Anne M Guiltinan1, Zhanna Kaidarova, Brian Custer

  • 1Blood Systems Research Institute, San Francisco, CA 94118, USA.

American Journal of Epidemiology
|January 22, 2008
PubMed

Insights

Hepatitis C virus (HCV) infection triples mortality in former blood donors. This includes increased deaths from liver disease, cardiovascular issues, and lifestyle-related causes like drug use and suicide.

Area of Science:

  • Epidemiology
  • Hepatology
  • Public Health

Background:

  • Hospital studies indicate high morbidity and mortality from Hepatitis C Virus (HCV) infection, including cirrhosis and liver cancer.
  • Epidemiologic studies present a less severe picture of HCV-related morbidity and mortality.
  • Discrepancies necessitate further investigation into HCV's long-term health impacts in diverse populations.

Purpose of the Study:

  • To evaluate the association between Hepatitis C Virus (HCV) infection and overall mortality.
  • To identify specific causes of excess mortality among HCV-positive individuals.
  • To compare mortality rates between HCV-positive and HCV-negative blood donors.

Main Methods:

  • Retrospective cohort study design.
  • Inclusion of 10,259 HCV antibody-positive (HCV+) and 10,259 matched HCV antibody-negative (HCV-) allogeneic blood donors (1991-2002).
  • Vital status ascertained through the US National Death Index through 2003; survival analysis used to calculate hazard ratios (HR) and 95% confidence intervals (CI).

Main Results:

  • A mean follow-up of 7.7 years revealed 601 deaths (2.92%), with 453 in the HCV+ group and 148 in the HCV- group (HR = 3.13, 95% CI: 2.60, 3.76).
  • Excess mortality in the HCV+ group was highest for liver-related causes (HR = 45.99), drug/alcohol-related causes (HR = 10.81), and trauma/suicide (HR = 2.99).
  • An unexpected significant increase in cardiovascular mortality was observed among HCV+ donors (HR = 2.21).

Conclusions:

  • HCV infection is linked to a threefold increase in overall mortality among former blood donors.
  • Significantly elevated mortality from liver and cardiovascular diseases is associated with HCV infection.
  • High mortality rates from drug/alcohol and trauma/suicide suggest the influence of lifestyle factors, potentially amenable to prevention.

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