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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...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2020
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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. |
format | Online Article Text |
id | pubmed-7443104 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
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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