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Liver Int. 2018 Feb;38(2):239-247. doi: 10.1111/liv.13501. Epub 2017 Jul 21.

Changing trends in complications of chronic hepatitis C.

Author information

1
Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, USA.
2
Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, MI, USA.
3
Division of Viral Hepatitis, National Center for HIV, Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
4
Department of Epidemiology and Health Services Research, Geisinger Health System, Danville, PA, USA.
5
Center for Health Research, Kaiser Permanente-Hawai'i, Honolulu, HI, USA.
6
Center for Health Research, Kaiser Permanente-Northwest, Portland, OR, USA.
7
Division of Gastroenterology and Hepatology, Henry Ford Health System, Detroit, MI, USA.

Abstract

BACKGROUND & AIMS:

Chronic hepatitis C virus (HCV)-related complications have increased over the past decade.

METHODS:

We used join-point regression modelling to investigate trends in these complications from 2006 to 2015, and the impact of demographics on these trends. Using data from the Chronic Hepatitis Cohort Study (CHeCS), we identified points at which the trend significantly changed, and estimated the annual percent change (APC) in rates of cirrhosis, decompensated cirrhosis and all-cause mortality, adjusted by race, sex and age.

RESULTS:

Among 11,167 adults with chronic HCV infection, prevalence of cirrhosis increased from 20.8% to 27.6% from 2006 to 2015, with adjusted annual percentage change (aAPC) of 1.2 (p <. 01). Although incidence of all-cause mortality increased from 1.8% in 2006 to 2.9% in 2015, a join-point was identified at 2010, with aAPCs of 9.6 before (2006 < 2010; p < .01) and -5.2 after (2010 ≤ 2015; p < .01), indicating a decrease in mortality from 2010 and onward. Likewise, overall prevalence of decompensated cirrhosis increased from 9.3% in 2006 to 10.4% in 2015, but this increase was confined to patients 60 or older (aAPC = 1.5; p = .023). Asian American and Black/African American patients demonstrated significantly higher rates of cirrhosis than White patients, while older patients and men demonstrated higher rates of cirrhosis and mortality.

CONCLUSIONS:

Although cirrhosis and mortality among HCV-infected patients in the US have increased over the past decade, all-cause mortality has decreased in recent years.

KEYWORDS:

African Americans; Asian Americans; cirrhosis; decompensated cirrhosis

PMID:
28636782
PMCID:
PMC5777910
DOI:
10.1111/liv.13501
[Indexed for MEDLINE]
Free PMC Article

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