Although liver-related mortality among those infected with hepatitis C is well documented, little is known about deaths in these patients that are not related to liver problems. A new study published in Clinical Infectious Diseases and now available online sought to determine mortality from all causes, including liver- and non-liver-related deaths among hepatitis C patients in the general U.S. population. The analysis found mortality from all causes to be higher in these patients.
An estimated 4 million adults in the U.S. tested positive for hepatitis C, according to the Third National Health and Nutritional Examination Survey, a large, nationally representative survey, conducted from 1988 to 1994. During a follow-up period of almost 15 years, 614 deaths occurred among 9,378 adults assessed in this study.
Among 203 people with chronic hepatitis C infection, 44 died, nine from liver-related causes. The remaining 35 deaths were due to HIV infection, diabetes, heart disease, cancer, and other causes. Compared to individuals who tested negative for hepatitis C, patients with chronic hepatitis C infection had more than a two-fold risk of dying from both liver- and non-liver related causes.
"This should reinforce the importance of preventive measures, particularly among individuals at-risk for acquiring the disease, as well as early diagnosis, and improving access to care for those already infected, even in the absence of liver disease," said the lead author of the study, Dr. Samer El-Kamary, of the University of Maryland School of Medicine in Baltimore. "While a hepatitis C infection itself may not be the cause of death, patients with the disease may be at a higher risk of dying due to other high-risk behaviors that may have also caused the infection. Furthermore, it is possible that other comorbidities like diabetes and cardiovascular disease could get worse if there is an underlying hepatitis C infection."
Dr. El-Kamary added, "Given the low cost for hepatitis C tests, perhaps it would be advisable to consider more liberal early screening of patients if there is any suspicion of infection so they can be referred for treatment as early as possible."
- Samer S. El-Kamary, Ravi Jhaveri, Michelle D. Shardell. All-Cause, Liver–, and Non–Liver-Related Mortality Among HCV-Infected Individuals in the General US Population. Clinical Infectious Diseases, 2011; DOI: 10.1093/cid/cir306
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