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

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 ca...

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Autores principales: Roelens, Maroussia, Bertisch, Barbara, Moradpour, Darius, Cerny, Andreas, Semmo, Nasser, Schmid, Patrick, Müllhaupt, Beat, Clerc, Olivier, Semela, David, Junker, Christoph, Negro, Francesco, Keiser, Olivia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7443104/
https://www.ncbi.nlm.nih.gov/pubmed/32855989
http://dx.doi.org/10.1093/ofid/ofaa308
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author Roelens, Maroussia
Bertisch, Barbara
Moradpour, Darius
Cerny, Andreas
Semmo, Nasser
Schmid, Patrick
Müllhaupt, Beat
Clerc, Olivier
Semela, David
Junker, Christoph
Negro, Francesco
Keiser, Olivia
author_facet Roelens, Maroussia
Bertisch, Barbara
Moradpour, Darius
Cerny, Andreas
Semmo, Nasser
Schmid, Patrick
Müllhaupt, Beat
Clerc, Olivier
Semela, David
Junker, Christoph
Negro, Francesco
Keiser, Olivia
author_sort Roelens, Maroussia
collection PubMed
description 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.
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spelling pubmed-74431042020-08-26 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 Müllhaupt, Beat Clerc, Olivier Semela, David Junker, Christoph Negro, Francesco Keiser, Olivia Open Forum Infect Dis Major Articles 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. Oxford University Press 2020-07-25 /pmc/articles/PMC7443104/ /pubmed/32855989 http://dx.doi.org/10.1093/ofid/ofaa308 Text en © The Author(s) 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Major Articles
Roelens, Maroussia
Bertisch, Barbara
Moradpour, Darius
Cerny, Andreas
Semmo, Nasser
Schmid, Patrick
Müllhaupt, Beat
Clerc, Olivier
Semela, David
Junker, Christoph
Negro, Francesco
Keiser, Olivia
All-Cause Mortality and Causes of Death in the Swiss Hepatitis C Cohort Study (SCCS)
title All-Cause Mortality and Causes of Death in the Swiss Hepatitis C Cohort Study (SCCS)
title_full All-Cause Mortality and Causes of Death in the Swiss Hepatitis C Cohort Study (SCCS)
title_fullStr All-Cause Mortality and Causes of Death in the Swiss Hepatitis C Cohort Study (SCCS)
title_full_unstemmed All-Cause Mortality and Causes of Death in the Swiss Hepatitis C Cohort Study (SCCS)
title_short All-Cause Mortality and Causes of Death in the Swiss Hepatitis C Cohort Study (SCCS)
title_sort all-cause mortality and causes of death in the swiss hepatitis c cohort study (sccs)
topic Major Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7443104/
https://www.ncbi.nlm.nih.gov/pubmed/32855989
http://dx.doi.org/10.1093/ofid/ofaa308
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