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J Viral Hepat. 2018 Feb;25(2):152-160. doi: 10.1111/jvh.12803. Epub 2017 Nov 20.

Trends in hepatitis C-related mortality in Switzerland.

Author information

1
Institute of Global Health, University of Geneva, Geneva, Switzerland.
2
Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
3
Gastroenterology and Hepatology University Hospital Zurich, Zurich, Switzerland.
4
Federal Statistical Office, Neuchâtel, Switzerland.
5
Hepatology, Department of Clinical Research, University of Bern, Bern, Switzerland.
6
University Clinic of Visceral Surgery and Medicine, Inselspital Bern, Bern, Switzerland.
7
Division of Gastroenterology and Hepatology, University Hospital Lausanne (CHUV), Lausanne, Switzerland.
8
Arud Centres for Addiction Medicine, Zurich, Switzerland.
9
Epatocentro Ticino, Lugano, Switzerland.
10
Division of Gastroenterology and Hepatology, St Gallen, Switzerland.
11
Checkpoint Zurich, Zurich, Switzerland.
12
Institute of Mathematical Statistics and Actuarial Science, University of Bern, Bern, Switzerland.
13
Divisions of Gastroenterology and Hepatology and of Clinical Pathology, University Hospitals Geneva, Geneva, Switzerland.

Abstract

In order to accurately assess the burden of hepatitis C (HCV) and develop effective interventions, we must understand the magnitude and trends of mortality related to the disease. In the United States, HCV-related mortality is continuously increasing. We have no comparable data for Switzerland and other European countries, although a modelling study predicted a similar increase. We analysed time trends (1 January 1995-31 December 2014) in HCV-specific mortality rates in the Swiss general population using the death registry of the Swiss Federal Statistical Office (SFSO). We compared HCV-related mortality to HIV-related and hepatitis B (HBV)-related mortality. To determine potential under-reporting in HCV-related mortality, we probabilistically linked the SFSO data to persons who died in the Swiss Hepatitis C Cohort Study (SCCS). SFSO data showed that HCV-related mortality more than doubled between 1995 and 2003, but has since stabilized at ~2.5/100 000 person-years. Since 2000, HCV-related mortality has been higher than HIV-related mortality and was about fivefold higher in 2014. HBV-related mortality remained low at ~0.5/100 000 person-years. Of 4556 persons in the SCCS, 421 have died and 86.2% could be linked to the death registry. According to the SCCS, 133 deaths were HCV-related. HCV was not mentioned on the SFSO death certificate of 45% of these (n = 60/133). In conclusion, HCV-related mortality remained constant, possibly because quality of care was high, or because of under-reporting or because mortality has not yet increased. However, HCV-related mortality is now much higher than HIV- and HBV-related mortality, and under-reporting was common.

KEYWORDS:

HIV; cohort; hepatitis B; hepatitis C; mortality

PMID:
29159841
DOI:
10.1111/jvh.12803
[Indexed for MEDLINE]

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