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Trends in mortality after diagnosis of hepatitis B or C infection: 1992-2006

Scott R Walter1, Hla-Hla Thein, Janaki Amin

  • 1National Centre in HIV Epidemiology and Clinical Research, The University of New South Wales, Sydney, Australia.

Journal of Hepatology
|December 15, 2010
PubMed

Insights

Chronic hepatitis B and C infections increase mortality risk, especially from liver and drug-related causes. Improved HBV treatment reduced liver deaths, while HCV drug-related deaths remain low due to harm reduction strategies.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Public Health

Background:

  • Chronic hepatitis B (HBV) and hepatitis C (HCV) infections are linked to increased mortality.
  • Liver- and drug-related causes contribute significantly to excess deaths in these populations.

Purpose of the Study:

  • To investigate specific causes of death in HBV and HCV cohorts.
  • To identify areas of excess mortality risk.
  • To analyze trends in mortality over time.

Main Methods:

  • Linked HBV and HCV case notifications (1992-2006) with cause of death and HIV/AIDS data in New South Wales.
  • Calculated mortality rates and standardized mortality ratios (SMRs) using person-time methodology.
  • Compared cohort mortality to the general New South Wales population.

Main Results:

  • The cohort included 42,480 HBV and 82,034 HCV mono-infected individuals.
  • HIV co-infection increased mortality 3-10 fold.
  • High excess mortality risk for liver-related deaths (HBV SMR 10.0, HCV SMR 15.8) and drug-related deaths (HCV SMR 15.4).
  • Hepatocellular carcinoma (HCC) mortality remained stable; non-HCC liver deaths decreased in HBV but not HCV.
  • HCV drug-related mortality stabilized after a 1999-2002 decrease.

Conclusions:

  • Improved HBV treatment likely reduced non-HCC liver mortality.
  • HCV drug-related mortality remains low, potentially due to improved harm reduction and opiate supply changes.
  • Continued monitoring and intervention are crucial for managing mortality risks in chronic viral hepatitis.
Abstract

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