New York survey shows mortality, comorbidity risk higher in HCV vs. HBV
Results of a recent mortality profile of New York City residents with hepatitis C and hepatitis B showed that patients with HCV were significantly more likely to have HIV coinfection, hepatocellular carcinoma, and lower survival rates compared with HBV.
“New York City (NYC) has a high burden of chronic hepatitis B (HBV) and hepatitis C virus (HCV) infection relative to the rest of the United States,” Miranda S. Moore, MPH, from the Bureau of Communicable Diseases in New York City, and colleagues wrote. “By 2013, deaths attributable to HCV surpassed deaths due to all nationally notifiable diseases combined, including HIV, highlighting the severity of the epidemic and its inuence on survival.”
To calculate the odds of comorbidity and mortality by viral hepatitis status, Moore and colleagues matched two previously generated data sources from the state’s Health Department and the New York State Cancer Registry.
The researchers identified 120,952 individuals with HBV and 127,922 individuals with HCV, as reported between 2001 and 2012 in NYC. During this period, more deaths occurred due to HCV than HBV (12.2% vs. 3.2%; P < .01).
HIV was more common among those with HCV than HBV (12.5% vs. 3.7%; P < .01), which remained significant after adjustment (aOR = 3.18; 95% CI, 3.06-3.3). Similarly, the researchers found more cases of HCC among individuals with HCV than HBV (2.1% vs. 1%), which was significantly higher after adjustment (aOR = 1.17; 95% CI, 1.09-1.26).
The 10-year survival rate was lower among individuals with HCV and HCC than infected individuals without HCC (35% vs. 83%). Similarly, the 10-year survival rate was lower among individuals with HBV and HCC than those infected individuals without HCC (52% vs. 96%).
In an adjusted analysis of mortality rates, individuals with HCV were significantly more likely to die after hepatitis diagnosis than those with HBV (HR = 2.04; 95% CI, 1.96-2.12).
“These findings emphasize the need for prevention activities, including preventing HIV coinfection and the provision of harm reduction services,” Moore and colleagues wrote. “For HCV, the urgency to treat and cure as many individuals as possible before they develop cirrhosis is even more tangible, as this will be an important way to reduce many of the drivers of morbidity and mortality, including liver disease and liver cancer. For HBV, the emphasis needs to be on appropriate monitoring of infection and control through treatment, as indicated, and appropriate screening for liver disease and HCC, given its outsize impact on mortality for these individuals.” – by Talitha Bennett
Disclosure: The authors report no relevant financial disclosures.