Esther J Aspinall1, Sharon J Hutchinson2, Naveed Z Janjua3, Jason Grebely4, Amanda Yu3, Maryam Alavi4, Janaki Amin4, David J Goldberg2, Hamish Innes2, Matthew Law4, Scott R Walter5, Mel Krajden3, Gregory J Dore4. 1. School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK; Health Protection Scotland, National Services Scotland, Glasgow, UK; The Kirby Institute, University of New South Wales, Sydney, Australia. Electronic address: Esther.Aspinall@nhs.net. 2. School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK; Health Protection Scotland, National Services Scotland, Glasgow, UK. 3. British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada; School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada. 4. The Kirby Institute, University of New South Wales, Sydney, Australia. 5. The Kirby Institute, University of New South Wales, Sydney, Australia; The Australian Institute of Health Innovation, University of New South Wales, Sydney, Australia.
Abstract
BACKGROUND & AIMS: People living with hepatitis C virus (HCV) are at increased risk of all-cause and liver-related mortality, although successful treatment has been shown to reduce this risk. The aim of this study was to provide baseline data on trends in cause-specific mortality and to establish an international surveillance system for evaluating the population level impact of HCV treatments. METHODS: Population level HCV diagnosis databases from Scotland (1997-2010), Australia (New South Wales [NSW]) (1997-2006), and Canada (British Columbia [BC]) (1997-2003) were linked to corresponding death registries using record linkage. For each region, age-adjusted cause-specific mortality rates were calculated, and trends in annual age-adjusted liver-related mortality were plotted. RESULTS: Of 105,138 individuals diagnosed with HCV (21,810 in Scotland, 58,484 in NSW, and 24,844 in BC), there were 7275 deaths (2572 in Scotland, 2655 in NSW, and 2048 in BC). Liver-related deaths accounted for 26% of deaths in Scotland, 21% in NSW, and 22% in BC. Temporal trends in age-adjusted liver related mortality were stable in Scotland (males p=0.4; females p=0.2) and NSW (males p=0.9; females p=0.9), while there was an increase in BC (males p=0.002; females p=0.04). CONCLUSIONS: The risk of liver-related mortality after a diagnosis of HCV has remained stable or increased over time across three regions with well-established diagnosis databases, highlighting that HCV treatment programmes to-date have had minimal impact on population level HCV-related liver disease. With more effective therapies on the horizon, and greater uptake of treatment anticipated, the potential of future therapeutic strategies to reduce HCV-related mortality is considerable.
BACKGROUND & AIMS:People living with hepatitis C virus (HCV) are at increased risk of all-cause and liver-related mortality, although successful treatment has been shown to reduce this risk. The aim of this study was to provide baseline data on trends in cause-specific mortality and to establish an international surveillance system for evaluating the population level impact of HCV treatments. METHODS: Population level HCV diagnosis databases from Scotland (1997-2010), Australia (New South Wales [NSW]) (1997-2006), and Canada (British Columbia [BC]) (1997-2003) were linked to corresponding death registries using record linkage. For each region, age-adjusted cause-specific mortality rates were calculated, and trends in annual age-adjusted liver-related mortality were plotted. RESULTS: Of 105,138 individuals diagnosed with HCV (21,810 in Scotland, 58,484 in NSW, and 24,844 in BC), there were 7275 deaths (2572 in Scotland, 2655 in NSW, and 2048 in BC). Liver-related deaths accounted for 26% of deaths in Scotland, 21% in NSW, and 22% in BC. Temporal trends in age-adjusted liver related mortality were stable in Scotland (males p=0.4; females p=0.2) and NSW (males p=0.9; females p=0.9), while there was an increase in BC (males p=0.002; females p=0.04). CONCLUSIONS: The risk of liver-related mortality after a diagnosis of HCV has remained stable or increased over time across three regions with well-established diagnosis databases, highlighting that HCV treatment programmes to-date have had minimal impact on population level HCV-related liver disease. With more effective therapies on the horizon, and greater uptake of treatment anticipated, the potential of future therapeutic strategies to reduce HCV-related mortality is considerable.
Authors: Matthew Hickman; John F Dillon; Lawrie Elliott; Daniela De Angelis; Peter Vickerman; Graham Foster; Peter Donnan; Ann Eriksen; Paul Flowers; David Goldberg; William Hollingworth; Samreen Ijaz; David Liddell; Sema Mandal; Natasha Martin; Lewis J Z Beer; Kate Drysdale; Hannah Fraser; Rachel Glass; Lesley Graham; Rory N Gunson; Emma Hamilton; Helen Harris; Magdalena Harris; Ross Harris; Ellen Heinsbroek; Vivian Hope; Jeremy Horwood; Sarah Karen Inglis; Hamish Innes; Athene Lane; Jade Meadows; Andrew McAuley; Chris Metcalfe; Stephanie Migchelsen; Alex Murray; Gareth Myring; Norah E Palmateer; Anne Presanis; Andrew Radley; Mary Ramsay; Pantelis Samartsidis; Ruth Simmons; Katy Sinka; Gabriele Vojt; Zoe Ward; David Whiteley; Alan Yeung; Sharon J Hutchinson Journal: BMJ Open Date: 2019-09-24 Impact factor: 2.692
Authors: Sahar Saeed; Erin C Strumpf; Erica Em Moodie; Jim Young; Roy Nitulescu; Joseph Cox; Alexander Wong; Sharon Walmsely; Curtis Cooper; Marie-Lousie Vachon; Valerie Martel-Laferriere; Mark Hull; Brian Conway; Marina B Klein Journal: J Int AIDS Soc Date: 2017-11 Impact factor: 5.396
Authors: Kuan Ken Lee; Dominik Stelzle; Rong Bing; Mohamed Anwar; Fiona Strachan; Sophia Bashir; David E Newby; Jasmit S Shah; Michael H Chung; Gerald S Bloomfield; Chris T Longenecker; Shashwatee Bagchi; Shyamasundaran Kottilil; Sarah Blach; Homie Razavi; Peter R Mills; Nicholas L Mills; David A McAllister; Anoop S V Shah Journal: Lancet Gastroenterol Hepatol Date: 2019-07-31