Mortality rates among individuals diagnosed with hepatitis c virus (HCV): An observational cohort study, England, 2008 to 2016

Georgina Ireland*, Sema Mandal, Matthew Hickman, Mary Ramsay, Ross Harris, Ruth Simmons

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)

Abstract

Background: Monitoring trends in mortality for individuals diagnosed with hepatitis C virus (HCV) infection are important as we expand treatment and move towards World Health Organization elimination targets. Aim: To estimate mortality rates for individuals aged ≥ 15 years diagnosed with HCV infection in England 2008–16. Methods: An observational cohort study whereby death certificate information was linked to the Sentinel Surveillance of Blood Borne Virus Testing in England. Age-sex standardised mortality rates (ASMR) for individuals diagnosed with HCV infection (2008–16) were calculated and compared to the general population. Results: Of 43,895 individuals with HCV infection, 2,656 (6.3%) died. All-cause ASMRs were 2,834.2 per 100,000 person years (PY), 2.3 times higher than in the general population. In individuals aged 30–69 years, all-cause mortality rates were 1,768.9 per 100,000 PY among individuals with HCV, 4.7 times higher than in the general population. ASMRs had not decreased between 2010 (2,992) and 2016 (2,340; p=0.10), with no change from 2014 (p = 0.058). ASMRs were 441.0 times higher for hepatitis, 34.4 times higher for liver cancer, 8.1 times higher for end stage liver disease and 6.4 times higher for external causes than in the general population. Conclusions: Mortality was higher in individuals with diagnosed HCV infection compared to the general opulation, highlighting health inequalities. There is a need to improve HCV diagnosis, engagement in care and treatment rates. Th high mortality from external causes highlights the importance of integrated health and social care strategies and addressing the needs of this vulnerable population.

Original languageEnglish
Article number1800695
JournalEurosurveillance
Volume24
Issue number30
DOIs
Publication statusPublished - 25 Jul 2019

Bibliographical note

Funding Information:
Funding: This report is independent research by the National Institute for Health Research. The research was funded by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections at UCL in partnership with Public Health England (PHE) and in collaboration with the London School of Hygiene and Tropical Medicine. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the National Institute for Health Research, the Department of Health or Public Health England.

Funding Information:
We thank the NIHR HPRU in Blood Borne and Sexually Transmitted Infections Steering Committee: Caroline Sabin (Director), Anthony Nardone (PHE Lead), Catherine Mercer, Gwenda Hughes, Jackie Cassell, Greta Rait, Samreen Ijaz, Tim Rhodes, Kholoud Porter, Sema Mandal and William Rosenberg, and the NIHR HPRU in Evaluation of Interventions at the University of Bristol in partnership with Public Health England. We are grateful to the late Sam Lattimore for his contribution to sentinel surveillance of blood-borne viruses and his vision and formative work on data linkage between hepatitis datasets. Funding: This report is independent research by the National Institute for Health Research. The research was funded by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections at UCL in partnership with Public Health England (PHE) and in collaboration with the London School of Hygiene and Tropical Medicine. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the National Institute for Health Research, the Department of Health or Public Health England.

Publisher Copyright:
© 2019, European Centre for Disease Prevention and Control (ECDC). All rights reserved.

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