The
disease burden and mortality related to hepatitis C are predicted to increase
in the United States as the number of persons with long-standing chronic HCV infection
grows, according to the authors of a study published in the April 2008 issue of
Hepatology.
The researchers analyzed hepatitis C mortality rates
derived from the U.S. census and multiple-cause-of-death data for 1995-2004. Deaths
were considered related to hepatitis C if either:
Hepatitis C was the underlying cause of death;
Chronic liver disease was the underlying cause and hepatitis
C was a contributing cause;
HIV was the underlying cause and chronic
liver disease and hepatitis C were contributing causes.
Results
A total of 56,409 hepatitis C-related deaths were identified during the 1995-2004
period.
Mortality rates increased 123% overall during the study period, from 1.09 to 2.44
cases per 100,000 persons.
However, average annual increases were smaller during 2000-2004 compared with
1995-1999.
After peaking in 2002 at 2.57 cases per 100,000 persons, overall hepatitis C mortality
rates declined slightly (to 2.44 cases), but continued to increase among individuals
aged 55-64 years.
Rates increased by 376% in the 45-54 age group and by 188% in the 55-64 age group.
Across age groups, increases were greater among men than women (144% vs 81%).
Rates increased more among non-Hispanic blacks (170%) and Native Americans (241%)
compared with non-Hispanic whites (124%) and Hispanics (84%).
The highest mortality rates in 2004 were observed among men, people aged 45-54
and 55-64 years, Hispanics, non-Hispanic blacks, and non-Hispanic Native American/Alaska
Natives.
The 7,427 hepatitis C deaths in 2004, occurring at a mean age of 55 years, corresponded
to 148,611 years of potential life lost.
Conclusion
A
CT scan of the upper abdomen showing a widespread (disseminated) carcinoma of
the liver (hepato cellular carcinoma). The
liver is the large organ on the left side of the picture.
"Overall,
hepatitis C mortality has increased substantially since 1995," the study
authors concluded. "Despite small declines in recent years, rates have continued
to increase among persons aged 55-64 years."
They added that, "Hepatitis
C is an important cause of premature mortality." The burden of HCV-related
morbidity and mortality in the most heavily affected age groups largely reflect
disease progression among people infected many years ago when awareness of the
diseases was poor' HCV was only identified as a distinct virus in 1992.
Department
of Epidemiology, School of Public Health, University of California, Los Angeles,
CA; Data Collection and Analysis Unit, Office of Health Assessment and Epidemiology,
Los Angeles County Department of Public Health, Los Angeles, CA; Division of Viral
Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention,
Centers for Disease Control and Prevention, Atlanta, GA.
4/04/08
Reference M
Wise, S Bialek, L Finelli L, Bell BP, et al. Changing trends in hepatitis C-related
mortality in the United States, 1995-2004. Hepatology 47(4): 1128-1135.
April 2008.