Deaths among people with hepatitis C in New York City, 2000-2011

Clin Infect Dis. 2014 Apr;58(8):1047-54. doi: 10.1093/cid/ciu075. Epub 2014 Feb 12.

Abstract

Background: Infection with hepatitis C virus (HCV) increases the risk of death from liver and nonliver-related diseases. Coinfection with human immunodeficiency virus (HIV) further increases this risk.

Methods: Surveillance data (2000-2010) and mortality data (2000-2011) maintained by the New York City Department of Health and Mental Hygiene (DOHMH) were deterministically cross-matched. Factors associated with and causes of death among HCV-infected adult decedents were analyzed.

Results: Between 2000 and 2011, 13 307 HCV-monoinfected adults died, and 5475 adults coinfected with HCV/HIV died. Decedents with HCV monoinfection were more likely to have died of liver cancer (odds ratio [OR] = 9.2), drug-related causes (OR = 4.3), and cirrhosis (OR = 3.7), compared with persons with neither infection. HCV/HIV-coinfected decedents were more likely to have died of liver cancer (OR = 2.2) and drug-related causes (OR = 3.1), compared with persons with neither infection. Among coinfected decedents, 53.6% of deaths were attributed to HIV/AIDS, and 94% of deaths occurred prematurely (before age 65). Among persons with HCV who died, more than half died within 3 years of an HCV report to DOHMH.

Conclusions: HCV-infected adults were at increased risk of dying and of dying prematurely, particularly from conditions associated with HCV, such as HIV/AIDS or drug use. The short interval between HCV report and death suggests a need for earlier testing and improved treatment.

Keywords: HIV; coinfection; hepatitis C; mortality; surveillance.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Comorbidity
  • Female
  • HIV Infections / complications
  • Hepatitis C / mortality*
  • Humans
  • Male
  • Middle Aged
  • New York City / epidemiology
  • Risk Factors
  • Substance-Related Disorders / complications
  • Survival Analysis
  • Young Adult