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Causes of Death in Individuals with Chronic HBV and/or HCV Infection

Studies of chronic viral hepatitis and mortality have often focused on selected populations or in countries with high rates of endemic viral hepatitis.

The aim of the present study, described in the April 4, 2008 advance online edition of the Journal of Viral Hepatitis, was to investigate the causes of death and mortality rates in the nationwide cohorts of people chronically infected with hepatitis B virus (HBV) and/or hepatitis C virus (HCV) in Sweden, where the rates of endemic viral hepatitis are low.

The Swedish researchers linked all notifications of chronic HBV infection and HCV infection in 1990-2003 to the Cause of Death Register. A total of 9517 people with chronic HBV infection, 34,235 people with chronic HCV infection and 1,601 with chronic HBV-HCV coinfection were included. The mean observation periods were 6.4, 6.3, and 7.9 years, respectively.

Mortality in the cohorts was compared with age- and sex-specific mortality in the general Swedish population and standardized mortality ratios (SMR) were calculated.

Results

• All-cause mortality increased significantly:

• HBV: SMR 2.3;
• HCV: SMR 5.8;
• HBV-HCV: SMR 8.5.

• There was a large excess of liver-related mortality in all cohorts:

• HBV: SMR 21.7;
• HCV: SMR 35.3;
• HBV-HCV: SMR 46.2.

• In HCV infected and HBV-HCV coinfected individuals, there was increased mortality due to drug-related psychiatric diagnoses (SMR 20.7 and 27.6, respectively) and external causes (SMR 12.4 and 11.4, respectively), predominantly among younger patients.

Conclusion

In conclusion, the study authors wrote, "This study demonstrated an increased all-cause mortality, with a great excess mortality from liver disease, in all cohorts."

They added that, "In people with HCV infection, the highest excess mortality in younger ages was from drug-related and external reasons."

Department of Infectious Diseases, Örebro University Hospital, Örebro, Sweden.

4/18/08

Reference

AS Duberg, A Törner, L Daviðsdóttir, and others. Cause of death in individuals with chronic HBV and/or HCV infection, a nationwide community-based register study. Journal of Viral Hepatitis. April 4, 2008 [Epub ahead of print].

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FDA-approved Combination Therapies for Chronic HCV Infection

Pegasys + Copegus
PEG-Intron + Rebetol
Intron A + Rebetol
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