All-Cause Mortality and Causes of Death in the Swiss Hepatitis C Cohort Study (SCCS).
- Roelens M Institute of Global Health, University of Geneva, Geneva, Switzerland.
- Bertisch B Institute of Global Health, University of Geneva, Geneva, Switzerland.
- Moradpour D Division of Gastroenterology and Hepatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
- Cerny A Fondazione Epatocentro Ticino, Lugano, Switzerland.
- Semmo N Department for BioMedical Research, Hepatology, University of Bern, Bern, Switzerland.
- Schmid P Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
- Müllhaupt B Swiss Hepato-Pancreato-Biliary Center and Department of Gastroenterology and Hepatology, University Hospital, Zürich, Switzerland.
- Clerc O Department of Internal Medicine and Infectious Diseases, Pourtalès Hospital, Neuchâtel, Switzerland.
- Semela D Division of Gastroenterology and Hepatology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
- Junker C Swiss Federal Statistical Office, Section Population Health, Neuchâtel, Switzerland.
- Negro F Division of Gastroenterology and Hepatology, University Hospitals Geneva, Geneva, Switzerland.
- Keiser O Institute of Global Health, University of Geneva, Geneva, Switzerland.
- 2020-08-29
Published in:
- Open forum infectious diseases. - 2020
English
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.
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.
- Language
-
- English
- Open access status
- gold
- Identifiers
-
- DOI 10.1093/ofid/ofaa308
- PMID 32855989
- Persistent URL
- https://sonar.ch/global/documents/187010
Statistics
Document views: 31
File downloads:
- Full-text: 0