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Records Show Deaths Associated with Hepatitis C Have Overtaken Deaths Caused by HIV: 'By 2007 hepatitis C-associated deaths had overtaken HIV as a cause of mortality in the United States. To achieve declines in mortality similar to those seen with HIV will require new policy directions and commitment to detect and link infected persons to care and successful treatment'
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AASLD Nov 5-8 2011 SF
By examining multiple-cause death records, researchers from the Centers for Disease Control and Prevention have determined that deaths from viral hepatitis are insufficiently appreciated and by 2007 were exceeding reported deaths caused by HIV.Approximately 21. 8 million records were included in the study, which was presented at the annual meeting of the American Association for the Study of Liver Diseases on Tuesday, November 8.
Those records were examined for mention of hepatitis B or C and for HIV. For the period of 1999 to 2007, deaths associated with hepatitis B remained constant, HIV declined, and hepatitis C increased -- significantly. Almost three-quarters of HCV-related deaths occurred in the 45-64 year-old age group. HIV was one of the comorbidities associated with viral hepatitis, as were chronic liver disease, other hepatitis virus, and alcohol-related conditions.
Scott Holmberg, MD, the study's presenter at the Liver Meeting® spoke directly to the conclusion of his team's study, which states a change in policy direction to improve detection and access to care for patients with hepatitis is required to decrease mortality associated with hepatitis, "Without reducing allocation of resources that have diminished HIV deaths, we think a commitment to detect and treat chronic HCV will markedly improve the growing wave of disability and death from this under-appreciated viral infection."
Previous studies have shown that only 40% to 50% of HCV-infected individuals are identified as such prior to death, whereas 80% to 85% of patients infected with HIV have been diagnosed before succumbing to their illness, he pointed out.
"If you consider the stability of the rates for hepatitis B and the declining death rates seen with HIV - those are most likely caused by improved awareness and advances in treatment of HIV," said AASLD president, T. Jake Liang, MD, tenured senior investigator and chief of the liver diseases branch at the National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, in Bethesda, Maryland. For HCV, "mortality has actually increased, and has surpassed HIV."
Dr. Liang noted that the increase is striking particularly hard at baby boomers. "This is a population that we are very concerned about. We really need to be more aggressive in terms of trying to identify who they are and getting them into treatment."
Abstract title:
The growing burden of mortality associated with viral hepatitis in the United States, 1999-2007
ABSTRACT
The Growing Burden of Mortality Associated with Viral Hepatitis in the United States, 1999-2007
S. D. Holmberg1; K. N. Ly1; J. Xing1; M. Klevens1; R. Jiles1; J. W. Ward1
1. Division of Viral Hepatitis, CDC, Atlanta, GA, United States.
Background: The increasing US health burden and mortality from viral hepatitis B and C are insufficiently appreciated.
Methods: National multiple-cause mortality data for 1999-2007, about 21.8 million records, were examined for any mention of hepatitis B virus (HBV), hepatitis C virus (HCV) and, for comparison, HIV infection. We assessed age-adjusted mortality rates, proportions of select sociodemographic characteristics, and potentially preventable co-morbidities in hepatitis B- and C-infected decedents in 2007.
Results: From 1999-2007, the HBV-related death rate was almost constant while deaths associated with"
hepatitis C increased significantly (annual age-adjusted mortality rate change, +0.18 deaths/100,000 per year) to a total of 15,106 deaths in 2007; by comparison, HIV deaths declined to 12,734 deaths in 2007.
Seventy-three percent of HCV and 59% of HBV-related deaths occurred in persons aged 45-64 yrs.
Co-morbidities associated with increased odds of hepatitis C-and B-related mortality included: chronic liver disease (adjusted odds ratio [ORadj,] 32.1 and 34.4, respectively); coinfection with the other hepatitis virus (ORadj, 29.9 and 31.5), alcohol-related conditions (ORadj, 4.6 and 3.7); and HIV co-infection (ORadj, 1.8 and 4.0).
Conclusions: By 2007 hepatitis C-associated deaths had overtaken HIV as a cause of mortality in the United States. To achieve declines in mortality similar to those seen with HIV will require new policy directions and commitment to detect and link infected persons to care and successful treatment.
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