Rates and Causes of Mortality among People in Care with Hepatitis C Virus Infection — Chronic Hepatitis Cohort Study (CHeCS), 2006–2010

Infectious Disease Week (IDWeek)
October 2-6, 2013
San Francisco, Ca

1774. Rates and Causes of Mortality among People in Care with Hepatitis C Virus Infection — Chronic Hepatitis Cohort Study (CHeCS), 2006–2010

Session: Poster Abstract Session: Viral Infections; Pathogenesis and Epidemiology

Saturday, October 5, 2013

Room: The Moscone Center: Poster Hall C

Posters Mahajan- IDSA- 9-2013.pdf (397.6 kB)

Background: To examine the association of hepatitis C virus (HCV) infection with all-cause and liver-related mortality, we analyzed data from a prospective observational cohort study in four health care systems in the United States.

Methods: We examined electronic health records of adults with at least one health system encounter from January 2006 through December 2010 from four integrated health care systems, and created a cohort of confirmed HCV-infected patients [Chronic Hepatitis Cohort Study (CHeCS)]. Cohort patients who died during 2006-2010 were analyzed.   All-cause and disease-specific death rates were calculated based upon US census data from 2006-2010.  Total number of deaths came from Multiple Cause of Death (MCOD) data based on 12 million death certificates for U.S. residents for the same time period.

Results: Of 2,143,369 adult patients with an encounter with the four CHeCS sites during 2006-2010, 11,703 (0.5%) had diagnosed chronic HCV infection. Of these, 1,590 (14%) died during 2006–2010; 75% of whom were born between 1945-1965, 50% were white, and 68% were men. Primary cause of death (498 of 1590) was liver disease unrelated to alcohol. Despite confirmed chronic HCV infection in those who died, only 19%had HCV infection listed as an underlying cause of death, and only 32% among those who died of primary liver cancer.   Mean age of death for HCV patients (59 years) was 15 years younger than in those without HCV infection from national data.  The age-adjusted mortality rate for liver disease in CHeCS was twelve times higher than the MCOD rate. 

Conclusion:    HCV infection was not listed as a cause of mortality in approximately 80% of confirmed HCV-infected persons; currently only 15,000 deaths have HCV infection listed on the death certificate.  Our data suggests that the national mortality rate of those with HCV could be as high as 75,000 persons per year, with over 60% of current deaths in our HCV-infected cohort directly attributable to liver disease.  Whether ascribed to liver-related causes or not, mortality in HCV-infected persons was 15 years younger compared with the national average in non-HCV infected persons.

Reena Mahajan, MD, MHS¹, Jian Xing, PhD¹, Stephen Liu, MPH¹, Kathleen Ly, MPH¹, Anne C. Moorman, BSN, MPH¹, Lora Rupp, MSE, MBA², Fujie Xu, MD, PhD¹, Scott Holmberg, MD, MPH¹ and for the Chronic Hepatitis Cohort Study (CHeCS) Investigators, (1)Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, GA, (2)Center for Health Services Research, Henry Ford Health System, Detroit, MI 

Disclosures:

R. Mahajan, None

J. Xing, None

S. Liu, None

K. Ly, None

A. C. Moorman, None

L. Rupp, None

F. Xu, None

S. Holmberg, None

Source