Mortality Among Patients With Chronic Hepatitis B Infection: The Chronic Hepatitis Cohort Study (CHeCS)

被引:41
作者
Bixler, Danae [1 ]
Zhong, Yuna [1 ,6 ]
Ly, Kathleen N. [1 ]
Moorman, Anne C. [1 ,6 ]
Spradling, Philip R. [1 ,6 ]
Teshale, Eyasu H. [1 ,6 ]
Rupp, Loralee B. [2 ]
Gordon, Stuart C. [2 ]
Boscarino, Joseph A. [3 ,7 ]
Schmidt, Mark A. [4 ,9 ]
Daida, Yihe G. [8 ]
Holmberg, Scott D. [1 ,5 ,6 ]
Ryerson, Blythe [6 ]
Nerenz, David R. [2 ]
Lu, Mei [2 ]
Lamerato, Lois [2 ]
Li, Jia [2 ]
Akkerman, Nonna [2 ]
Zhang, Talan [2 ]
Trudeau, Sheri [2 ]
Zhou, Yueren [2 ]
Wu, Kuan-Han
Daar, Zahra S. [7 ]
Smith, Robert E. [7 ]
Trinacty, Connie Mah [8 ]
Lai, Jonathan W. [8 ]
Wong, Carmen P. [8 ]
Donald, Judy L. [9 ]
机构
[1] Ctr Dis Control & Prevent, Div Viral Hepatitis, 1600 Clifton Rd, Atlanta, GA 30329 USA
[2] Henry Ford Hlth Syst, Detroit, MI USA
[3] Geisinger Hlth Syst, Danville, PA USA
[4] Kaiser Permanente Northwest, Portland, OR USA
[5] Kaiser Permanente, Honolulu, HI USA
[6] Ctr Dis Control & Prevent CDC, Natl Ctr HIV Viral Hepatitis STD & TB Prevent NCH, Div Viral Hepatitis, Atlanta, GA USA
[7] Geisinger Med Clin, Dept Epidemiol & Hlth Serv Res, Danville, PA USA
[8] Kaiser Permanente Hawaii, Ctr Hlth Res, Honolulu, HI USA
[9] Kaiser Permanente Northwest, Ctr Hlth Res, Portland, OR USA
关键词
chronic hepatitis B; mortality; liver disease; risk factors; cause of death; C VIRUS-INFECTION; CHRONIC LIVER-DISEASE; HEPATOCELLULAR-CARCINOMA; UNITED-STATES; VIRAL-HEPATITIS; INTERNATIONAL CLASSIFICATION; VACCINATION COVERAGE; CARE-DELIVERY; SURVEILLANCE; COINFECTION;
D O I
10.1093/cid/ciy598
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background According to death certificates, approximately 1800 persons die from hepatitis B annually in the United States; however, this figure may underestimate true mortality from chronic hepatitis B (CHB). Methods We analyzed data from CHB patients seen in the Chronic Hepatitis Cohort Study (CHeCS) between 1 January 2006 and 31 December 2013. We compared overall and cause-specific death rates and mean ages at death between CHeCS CHB decedents and U.S. decedents from the Multiple Cause of Death (MCOD) file. Results Of 4389 CHB patients followed for a mean of 5.38 years, 492 (11%) CHB patients died after a mean follow-up of 3.00 years. Compared to survivors, decedents were older, more likely to be White (40.6%), African-American (27.1%), or male (74.2%); and more likely to have had cirrhosis (59.8%), diabetes (27.2%), alcohol abuse (17.7%), hepatocellular carcinoma (17.5%), or a liver transplant (5.7%); whereas survivors were more likely to be Asian (48.8%; all P < .001). CHB patients died at an average age of 59.8 years14 years younger than the general U.S. populationand at higher rates for all causes (relative risk [RR] = 1.85, 95% confidence interval [CI], 1.851-1.857) and liver-related causes (RR = 15.91, 95% CI, 15.81-16.01). Only 19% of CHB decedents and 40% of those dying of liver disease had hepatitis B reported on their death certificates. Conclusions Compared to the general population, CHB patients die at younger ages and higher rates from all causes and liver-related causes. Death certificates underrepresent the true mortality from CHB. Half of decedents with chronic hepatitis B (CHB) died of liver-related causes, at an average age of 60 years. Despite this, only 40% of CHB decedents dying with liver disease had hepatitis B reported on the death certificate.
引用
收藏
页码:956 / 963
页数:8
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