 HIV
Coinfection Contributes to Mortality Related to Chronic Hepatitis B and C in France
 Since
the advent of effective antiretroviral
therapy has reduced the rate of death due to opportunistic illnesses and other
AIDS-related causes, liver disease has emerged as a major cause of death among
HIV positive people. HIV, in turn, has also
influenced rates of death among patients with chronic
hepatitis B virus (HBV) or hepatitis C virus (HCV)
infection, according to a study published in the February 2008 Journal
of Hepatology.
In this analysis, Patrick Marcellin and colleagues estimated
mortality related to HCV and HBV infection in France. A random sample of 999 death
certificates was obtained from among all 65,000 French death certificates in 2001
that listed HBV, HCV, hepatitis, liver disease, possible complication of cirrhosis,
bacterial infection, HIV, or transplantation
as causes of death. Physicians who reported these deaths were sent a questionnaire
to identify how many deaths were related to HBV or HCV infection. Death rates
were then estimated according to national population census data.
 Results
•
The
estimated annual number of deaths associated with HCV was 3618 (6.1 deaths per
100,000 inhabitants).
•
The
estimated annual number of deaths associated with HBV was 1507 (2.5 per 100,000
inhabitants).
•
The
estimated number of deaths attributable to HCV was 2646 (4.5 per 100,000 inhabitants).
•
The
estimated number of deaths attributable to HBV was 1327 (2.2 per 100,000 inhabitants).
•
In
the HCV infected group, 95% had cirrhosis and 33% had hepatocellular carcinoma
(HCC).
•
In
the HBV infected group, the rates were similar: 93% and 35%, respectively.
•
11%
percent of these deaths occurred in patients with HIV coinfection.
•
Deaths
related to hepatitis B or C occurred at an earlier age in patients with a history
of excessive alcohol consumption.
Conclusion
"In
France, 4000-5000 deaths related to HCV and HBV infection occurred in 2001,"
the researchers concluded. "Alcohol consumption and HIV infection were important
co-factors."
They added that, "These data emphasize the need
for ongoing, efficient public health programs that include screening, management,
and counseling for HCV- and HBV-infected
individuals."
02/29/08
Reference
P Marcellin,
F Pequignot, E Delarocque-Astagneau, and others. Mortality related to chronic
hepatitis B and chronic hepatitis C in France: Evidence for the role of HIV coinfection
and alcohol consumption. Journal of Hepatology 48(2): 200-207. February
2008. |
| |
