Hepatitis C Surpasses HIV as Cause of Death in U.S.
Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death File. CDC WONDER Online Database: http://wonder.cdc.gov/mcd-icd10.html
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The Growing Burden of Mortality from Viral Hepatitis in the United States, 1999-2007
Abstract:
Background: The increasing US health burden and mortality from hepatitis B and C are insufficiently appreciated.
Methods: National multiple-cause-of-death data for 1999-2007, about 22 million records, were analyzed for any mention of hepatitis B virus (HBV), hepatitis C virus (HCV) and, for comparison, HIV infection. We assessed age- adjusted mortality rates, socio-demographic characteristics, and potentially preventable co-morbidities in HBV- and HCV-infected decedents in 2007.
Results: From 1999-2007, the HBV-related death rate was nearly constant while deaths with hepatitis C increased significantly (annual mortality rate change, +0.18 deaths/100,000 per year) to 15,106 deaths in 2007; by comparison, HIV deaths declined to 12,734 deaths in 2007. Of HCV-related deaths, 73.4% occurred among persons aged 45-64 years. Co-morbidities associated with increased odds of HCV-related mortality included: chronic liver disease (adjusted odds ratio [ORadj,], 32.1); HBV co-infection , alcohol-related conditions; HIV co-infection; and being a member of a minority group . Like HCV, most deaths in HBV-infected persons occurred in those aged 45- 64 years (59.4%). Factors increasing odds of HBV-related death included: Asian/Pacific Islander identity (various models, ORadj, 13.1 – 17.2); chronic liver disease); HCV co-infection ; HIV co-infection (ORadj, 4.0); and alcohol-related conditions.
Conclusions: Our analysis indicates that by 2007 HCV had overtaken HIV as a cause of mortality and that deaths in HCV-infected persons were isproportionately among middle-aged persons and minorities. To achieve declines in mortality similar to those seen with HIV will require new policy directions and commitment to detect and link chronic hepatitis patients to care and treatment.
