Mortality in patients with chronic and cleared hepatitis C viral infection: a nationwide cohort study

Lars Haukali Omland; Henrik Krarup; Peter Jepsen; Jørgen Georgsen; Lene Holm Harritshøj; Kirsten Riisom; Svend Erik Hove Jacobsen; Per Schouenborg; Peer Brehm Christensen; Henrik Toft Sørensen; Niels Obel; Jette Marie Bangsborg; DANVIR Cohort Study

doi:10.1016/j.jhep.2010.01.033

Mortality in patients with chronic and cleared hepatitis C viral infection: a nationwide cohort study

Lars Haukali Omland, Henrik Krarup, Peter Jepsen, Jørgen Georgsen, Lene Holm Harritshøj, Kirsten Riisom, Svend Erik Hove Jacobsen, Per Schouenborg, Peer Brehm Christensen, Henrik Toft Sørensen, Niels Obel, Jette Marie Bangsborg, DANVIR Cohort Study

Department of Immunology and Microbiology

65 Citations (Scopus)

Abstract

Background & Aims: It is unknown whether mortality differs between patients with chronic hepatitis C virus (HCV) replication and those who cleared the virus after infection. We examined the impact of chronic HCV replication on mortality among Danish patients testing positive for HCV antibodies. Methods: This nationwide cohort study focused on Danish patients with at least one HCV RNA measurement available after testing positive for HCV antibodies between 1996 and 2005. To capture long-term prognosis, eligible patients needed to be alive 1 year after HCV RNA assessment. We estimated mortality rate ratios (MRRs) using Cox regression (for overall mortality) and subdistribution hazard ratios (SDHRs) for cause-specific mortality, controlling for gender, age, comorbidity, calendar period, alcohol abuse, injection drug use, and income. Results: Of the 6292 patients under study, 63% had chronic HCV-infection and 37% had cleared the virus. Five-year survival was 86% (95% confidence interval (CI): 84-87%) in the chronic HCV group and 92% (95% CI: 91-94%) in the cleared HCV group. Chronic HCV-infection was associated with higher overall mortality (MRR: 1.55, 95% CI: 1.28-1.86) and liver-related death (SDHR: 2.42, 95% CI: 1.51-3.88). Chronic HCV-infection greatly increased the risk of death from primary liver cancer (SDHR: 16.47, 95% CI: 2.24-121.00). Conclusions: Patients with chronic HCV-infection are at higher risk of death than patients who cleared the infection. The substantial association found between chronic HCV-infection and death from primary liver cancer supports early initiation of antiviral treatment in chronically HCV-infected patients.

Original language	English
Journal	Journal of Hepatology
Volume	53
Issue number	1
Pages (from-to)	36-42
Number of pages	7
ISSN	0168-8278
DOIs	https://doi.org/10.1016/j.jhep.2010.01.033
Publication status	Published - 1 Jul 2010

Keywords

Adult
Cohort Studies
Denmark
Female
Hepacivirus
Hepatitis C
Hepatitis C, Chronic
Humans
Kaplan-Meier Estimate
Male
Middle Aged
RNA, Viral
Virus Replication

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.jhep.2010.01.033

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Omland, L. H., Krarup, H., Jepsen, P., Georgsen, J., Harritshøj, L. H., Riisom, K., Jacobsen, S. E. H., Schouenborg, P., Christensen, P. B., Sørensen, H. T., Obel, N., Bangsborg, J. M., & DANVIR Cohort Study (2010). Mortality in patients with chronic and cleared hepatitis C viral infection: a nationwide cohort study. Journal of Hepatology, 53(1), 36-42. https://doi.org/10.1016/j.jhep.2010.01.033

Omland, LH, Krarup, H, Jepsen, P, Georgsen, J, Harritshøj, LH, Riisom, K, Jacobsen, SEH, Schouenborg, P, Christensen, PB, Sørensen, HT, Obel, N, Bangsborg, JM & DANVIR Cohort Study 2010, 'Mortality in patients with chronic and cleared hepatitis C viral infection: a nationwide cohort study', Journal of Hepatology, vol. 53, no. 1, pp. 36-42. https://doi.org/10.1016/j.jhep.2010.01.033

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abstract = "Background & Aims: It is unknown whether mortality differs between patients with chronic hepatitis C virus (HCV) replication and those who cleared the virus after infection. We examined the impact of chronic HCV replication on mortality among Danish patients testing positive for HCV antibodies. Methods: This nationwide cohort study focused on Danish patients with at least one HCV RNA measurement available after testing positive for HCV antibodies between 1996 and 2005. To capture long-term prognosis, eligible patients needed to be alive 1 year after HCV RNA assessment. We estimated mortality rate ratios (MRRs) using Cox regression (for overall mortality) and subdistribution hazard ratios (SDHRs) for cause-specific mortality, controlling for gender, age, comorbidity, calendar period, alcohol abuse, injection drug use, and income. Results: Of the 6292 patients under study, 63% had chronic HCV-infection and 37% had cleared the virus. Five-year survival was 86% (95% confidence interval (CI): 84-87%) in the chronic HCV group and 92% (95% CI: 91-94%) in the cleared HCV group. Chronic HCV-infection was associated with higher overall mortality (MRR: 1.55, 95% CI: 1.28-1.86) and liver-related death (SDHR: 2.42, 95% CI: 1.51-3.88). Chronic HCV-infection greatly increased the risk of death from primary liver cancer (SDHR: 16.47, 95% CI: 2.24-121.00). Conclusions: Patients with chronic HCV-infection are at higher risk of death than patients who cleared the infection. The substantial association found between chronic HCV-infection and death from primary liver cancer supports early initiation of antiviral treatment in chronically HCV-infected patients.",

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doi = "10.1016/j.jhep.2010.01.033",

language = "English",

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T1 - Mortality in patients with chronic and cleared hepatitis C viral infection: a nationwide cohort study

AU - Omland, Lars Haukali

AU - Krarup, Henrik

AU - Jepsen, Peter

AU - Georgsen, Jørgen

AU - Harritshøj, Lene Holm

AU - Riisom, Kirsten

AU - Jacobsen, Svend Erik Hove

AU - Schouenborg, Per

AU - Christensen, Peer Brehm

AU - Sørensen, Henrik Toft

AU - Obel, Niels

AU - Bangsborg, Jette Marie

AU - DANVIR Cohort Study

PY - 2010/7/1

Y1 - 2010/7/1

N2 - Background & Aims: It is unknown whether mortality differs between patients with chronic hepatitis C virus (HCV) replication and those who cleared the virus after infection. We examined the impact of chronic HCV replication on mortality among Danish patients testing positive for HCV antibodies. Methods: This nationwide cohort study focused on Danish patients with at least one HCV RNA measurement available after testing positive for HCV antibodies between 1996 and 2005. To capture long-term prognosis, eligible patients needed to be alive 1 year after HCV RNA assessment. We estimated mortality rate ratios (MRRs) using Cox regression (for overall mortality) and subdistribution hazard ratios (SDHRs) for cause-specific mortality, controlling for gender, age, comorbidity, calendar period, alcohol abuse, injection drug use, and income. Results: Of the 6292 patients under study, 63% had chronic HCV-infection and 37% had cleared the virus. Five-year survival was 86% (95% confidence interval (CI): 84-87%) in the chronic HCV group and 92% (95% CI: 91-94%) in the cleared HCV group. Chronic HCV-infection was associated with higher overall mortality (MRR: 1.55, 95% CI: 1.28-1.86) and liver-related death (SDHR: 2.42, 95% CI: 1.51-3.88). Chronic HCV-infection greatly increased the risk of death from primary liver cancer (SDHR: 16.47, 95% CI: 2.24-121.00). Conclusions: Patients with chronic HCV-infection are at higher risk of death than patients who cleared the infection. The substantial association found between chronic HCV-infection and death from primary liver cancer supports early initiation of antiviral treatment in chronically HCV-infected patients.

AB - Background & Aims: It is unknown whether mortality differs between patients with chronic hepatitis C virus (HCV) replication and those who cleared the virus after infection. We examined the impact of chronic HCV replication on mortality among Danish patients testing positive for HCV antibodies. Methods: This nationwide cohort study focused on Danish patients with at least one HCV RNA measurement available after testing positive for HCV antibodies between 1996 and 2005. To capture long-term prognosis, eligible patients needed to be alive 1 year after HCV RNA assessment. We estimated mortality rate ratios (MRRs) using Cox regression (for overall mortality) and subdistribution hazard ratios (SDHRs) for cause-specific mortality, controlling for gender, age, comorbidity, calendar period, alcohol abuse, injection drug use, and income. Results: Of the 6292 patients under study, 63% had chronic HCV-infection and 37% had cleared the virus. Five-year survival was 86% (95% confidence interval (CI): 84-87%) in the chronic HCV group and 92% (95% CI: 91-94%) in the cleared HCV group. Chronic HCV-infection was associated with higher overall mortality (MRR: 1.55, 95% CI: 1.28-1.86) and liver-related death (SDHR: 2.42, 95% CI: 1.51-3.88). Chronic HCV-infection greatly increased the risk of death from primary liver cancer (SDHR: 16.47, 95% CI: 2.24-121.00). Conclusions: Patients with chronic HCV-infection are at higher risk of death than patients who cleared the infection. The substantial association found between chronic HCV-infection and death from primary liver cancer supports early initiation of antiviral treatment in chronically HCV-infected patients.

KW - Adult

KW - Cohort Studies

KW - Denmark

KW - Female

KW - Hepacivirus

KW - Hepatitis C

KW - Hepatitis C, Chronic

KW - Humans

KW - Kaplan-Meier Estimate

KW - Male

KW - Middle Aged

KW - RNA, Viral

KW - Virus Replication

U2 - 10.1016/j.jhep.2010.01.033

DO - 10.1016/j.jhep.2010.01.033

M3 - Journal article

C2 - 20400197

SN - 0169-5185

VL - 53

SP - 36

EP - 42

JO - Journal of Hepatology, Supplement

JF - Journal of Hepatology, Supplement

IS - 1

ER -

Mortality in patients with chronic and cleared hepatitis C viral infection: a nationwide cohort study

Abstract

Keywords

UN SDGs

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