As
reported in the April 2007 issue of Hepatology,
researchers conducted a large study to investigate all-cause mortality among individuals
with HBV and/or HCV
in a community-based setting. The study
population included individuals with viral hepatitis reported to the New
South Wales state health department in Australia
between 1990 and 2002:
39,109 with HBV;
75,834 with HCV;
2,604 with HBV-HCV coinfection.
Data
were probabilistically linked to the National Death Index, and standardized mortality
ratios for all causes of death were calculated and adjusted for age, sex, and
calendar year.
Results
The number of deaths identified
by the linkage were:
1233 (3.2%) in patients with
hepatitis B;
4008 (5.3%) in patients with
hepatitis C;
186 (7.1%) in HBV-HCV coinfected patients.
Standardized mortality ratios
revealed an increased risk of liver-related death:
12.2 for patients with HBV;
16.8 for patients with HCV;
32.9 for HBV-HCV coinfected patients.
Mortality ratios also showed an
increased risk of drug-induced death:
1.4 for patients with HBV;
19.3 for patients with HCV;
24.7 for HBV-HCV coinfected patients.
In people with hepatitis C, the
increase in the risk of death from drug-related causes was significantly greater
than from liver-related causes (P = 0.012).
The greatest excess risk was observed
in women age 15-24 years.
Conclusion
“All
groups [with HBV and/or HCV] had increased risk of liver-related death compared with the standard population, with the greatest
excess in people diagnosed with hepatitis B and hepatitis C coinfection,” the researchers concluded. “Our data highlight
that young people with hepatitis C and with [HBV-HCV] coinfection face a higher mortality risk from continued drug
use than from their infection, whereas the main cause of hepatitis B death was
liver related.”
05/15/07
Reference F Tacke and C Trautwein.Causes of death
in hepatitis B and/or C virus infected-people-lessons for clinical practice.Hepatology 45(4): 1076-1077. April 2007.
