All-Cause Mortality and Causes of Death in the Swiss Hepatitis C Cohort Study (SCCS).

Roelens, Maroussia; Bertisch, Barbara; Moradpour, Darius; Cerny, Andreas; Semmo, Nasser; Schmid, Patrick; Mülhaupt, Beat; Clerc, Olivier; Semela, David; Junker, Christoph; Negro, Francesco; Keiser, Olivia; Hepatitis C Cohort Study, Swiss (2020). All-Cause Mortality and Causes of Death in the Swiss Hepatitis C Cohort Study (SCCS). Open Forum Infectious Diseases, 7(8), ofaa308. Oxford University Press 10.1093/ofid/ofaa308

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Background

With direct-acting antiviral agents (DAAs), mortality rates and causes of death among persons with hepatitis C virus (HCV) infection may change over time. However, the emergence of such trends may be delayed by the slow progression of chronic hepatitis C. To date, detailed analyses of cause-specific mortality among HCV-infected persons over time remain limited.

Methods

We evaluated changes in causes of death among Swiss Hepatitis C Cohort Study (SCCS) participants from 2008 to 2016. We analyzed risk factors for all-cause and cause-specific mortality, accounting for changes in treatment, fibrosis stage, and use of injectable drugs over time. Mortality ascertainment was completed by linking lost-to-follow-up participants to the Swiss Federal Statistical Office death registry.

Results

We included 4700 SCCS participants, of whom 478 died between 2008 and 2016. The proportion of unknown causes of death decreased substantially after linkage, from 42% to 10%. Leading causes of death were liver failure (crude death rate 4.4/1000 person-years), liver cancer (3.4/1000 person-years), and nonliver cancer (2.8/1000 person-years), with an increasing proportion of cancer-related deaths over time. Cause-specific analysis showed that persons with sustained virologic response were less at risk for liver-related mortality than those never treated or treated unsuccessfully.

Conclusions

Although the expected decrease in mortality is not yet observable, causes of death among HCV-infected persons have evolved over time. With the wider use of DAAs, liver-related mortality is expected to decline in the future. Continued monitoring of cause-specific mortality will remain important to assess the long-term effect of DAAs and design effective interventions.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Hepatologie
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Hepatologie

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Hepatology

UniBE Contributor:

Semmo, Nasser

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2328-8957

Publisher:

Oxford University Press

Language:

English

Submitter:

Rahel Fuhrer

Date Deposited:

09 Dec 2020 08:59

Last Modified:

13 Dec 2020 02:51

Publisher DOI:

10.1093/ofid/ofaa308

PubMed ID:

32855989

Uncontrolled Keywords:

Switzerland cohort hepatitis C mortality risk factors

BORIS DOI:

10.7892/boris.148114

URI:

https://boris.unibe.ch/id/eprint/148114

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