Ly KN. Ann Intern Med. 2012;156:271-278.
By 2007, more people died of hepatitis C virus than HIV
in the United States, and deaths from hepatitis C and hepatitis B virus
occurred disproportionately in the middle-aged, according to researchers from
the CDC.
The rate of HCV deaths increased from 1999 to 2007;
there was a statistically significant annual age-adjusted mortality rate
increase of 0.18 deaths/100,000 people. However, there was a statistically
significant annual age-adjusted mortality rate decrease of 0.21 deaths/100,000
people.
Researchers pooled data on multiple-cause mortality from
1999 to 2007 from the National Center for Health Statistics. They examined
mortality from HBV, HCV and, for comparison, HIV. The data came from all of the
US states and the District of Columbia, and included 22 million deaths.
In 2007, the mortality rate of HCV surpassed the
mortality rate of HIV. The mortality rate of HBV remained constant. The
greatest proportion of HCV- and HBV-related deaths occurred in middle-aged
adults.
Compared with women, men had more HCV- and HBV-related
deaths. Specifically, there were more HBV-related deaths among those with Asian
or Pacific Islander descent. Those who died of HBV or HCV frequently had
coinfection with HIV or HBV or HCV and had chronic liver disease or
alcohol-related condition.
“Despite declines in the estimated incidence of HBV
and HCV infections, the size of the population living with viral hepatitis is
considerable,” the researchers wrote. “An estimated 800,000 to 1.4
million persons are living with hepatitis B … approximately 3.2 million
persons in the United States are living with chronic hepatitis C.”
Disclosure: The researchers report no relevant financial
disclosures.
Kevin Fenton, MD
The data from this report underscore the urgent need to address the health threat posed by chronic hepatitis B and C in the United States: Millions of Americans are infected with viral hepatitis, but many do not know it and may suffer serious health consequences; chronic hepatitis is a leading and preventable cause of premature death in the United States; and over time, leaving viral hepatitis untreated can lead to costly care and treatments, and lifetime costs can total hundreds of thousands of dollars. Early detection and intervention, however, can be cost-effective and save lives. Chronic hepatitis B and C virus infections affect millions of Americans – approximately 3.5-5.3 million people (approximately 2.7-3.9 million for hepatitis C and approximately 700,000-1.4 million for hepatitis B) – yet these infections are often unrecognized and go untreated. As the population living with hepatitis C in the United States (66 percent of whom were born between 1945 and 1964) has aged and entered a high risk period of life for HCV-related disease, deaths associated with hepatitis C have increased substantially between the years of 1999 and 2007. Most of these deaths are occurring among middle-aged individuals and, in fact, 73 percent of hepatitis C deaths were reported among those 45 – 64 years old. This article highlights the need to increase awareness of the burden of chronic hepatitis in the United States and the critical importance of hepatitis screening. It also highlights the need to increase the number of individuals diagnosed and linked to treatment and other needed services that can prevent hepatitis related disease and deaths.
-Kevin Fenton, MD
Infectious Disease News Editorial Board member
Disclosure: Dr. Fenton reports no relevant financial disclosures.