Trends in mortality after diagnosis of hepatitis C virus infection

an international comparison and implications for monitoring the population impact of treatment

Esther J. Aspinall*, Sharon J. Hutchinson, Naveed Z. Janjua, Jason Grebely, Amanda Yu, Maryam Alavi, Janaki Amin, David J. Goldberg, Hamish Innes, Matthew Law, Scott R. Walter, Mel Krajden, Gregory J. Dore

*Corresponding author for this work

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Background & Aims: People living with hepatitis C virus (HCV) are at increased risk of all-cause and liver-related mortality, although successful treatment has been shown to reduce this risk. The aim of this study was to provide baseline data on trends in cause-specific mortality and to establish an international surveillance system for evaluating the population level impact of HCV treatments.

Methods: Population level HCV diagnosis databases from Scotland (1997-2010), Australia (New South Wales [NSW]) (1997-2006), and Canada (British Columbia [BC]) (1997-2003) were linked to corresponding death registries using record linkage. For each region, age-adjusted cause-specific mortality rates were calculated, and trends in annual age-adjusted liver-related mortality were plotted.

Results: Of 105,138 individuals diagnosed with HCV (21,810 in Scotland, 58,484 in NSW, and 24,844 in BC), there were 7275 deaths (2572 in Scotland, 2655 in NSW, and 2048 in BC). Liver-related deaths accounted for 26% of deaths in Scotland, 21% in NSW, and 22% in BC. Temporal trends in age-adjusted liver related mortality were stable in Scotland (males p = 0.4; females p = 0.2) and NSW (males p = 0.9; females p = 0.9), while there was an increase in BC (males p = 0.002; females p = 0.04).

Conclusions: The risk of liver-related mortality after a diagnosis of HCV has remained stable or increased over time across three regions with well-established diagnosis databases, highlighting that HCV treatment programmes to-date have had minimal impact on population level HCV-related liver disease. With more effective therapies on the horizon, and greater uptake of treatment anticipated, the potential of future therapeutic strategies to reduce HCV-related mortality is considerable.

Original languageEnglish
Pages (from-to)269-277
Number of pages9
JournalJournal of Hepatology
Volume62
Issue number2
DOIs
Publication statusPublished - Feb 2015
Externally publishedYes

Keywords

  • Hepatitis C
  • Hepatitis C therapies
  • Liver-related mortality

Cite this