Although the death rate from hepatitis C virus infection is increasing, it is relatively low compared to other causes of death—or so we thought. CDC researchers gathered data* from health records of 2,143,369 adults seen in four health care systems (CHeCS) in the U.S. Looking at all-cause and liver-related mortality along with evidence of hepatitis C, these were compared to mortality rates of 12 million death certificates for U.S. residents in the years 2006-2010.
Of the hepatitis C patients seen at the CHeCS, the primary cause of death was liver disease unrelated to alcohol. However, hepatitis C was listed as a cause of death only 19% of the time. Estimated mortality rate was twelve times higher than the general population. Regardless of whether the cause of death was liver-related or not, mortality in hepatitis C-infected persons was 15 years younger compared with the national average in non-hepatitis C infected persons.
These data suggest that the mortality rate of those with hepatitis C could be as high as 75,000 persons per year and that the hepatitis C mortality data may be under-reported at 15,000 annual deaths. This is disturbing on so many levels. Patients have been told for years that the risk of death was low. For many years I would try to reassure patients with the fact that more people die with hepatitis C than from hepatitis C. Although this is true, it isn’t completely true. It undermines the truth, which is that hepatitis C is a potentially grave disease that deserves to be taken seriously.
From a public health perspective, hepatitis C has been underfunded and under-noticed. With a mortality rate twelve times higher than previously reported, and death occurring 15 years younger, hepatitis C should be a health policy priority. Starting now—not later—now.
(* Source: Mortality among Persons in Care with Hepatitis C Virus Infection—Chronic Hepatitis Cohort Study (CHeCS), 2006 -2010 – Reena Mahajan, et al. at Centers for Disease Control and Prevention - Presentation at Infectious Diseases (ID) Week 2013)