Epidemiology

Continued drug use main risk of death for hepatitis C patients

Last Updated: 2006-09-07 18:38:41 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Individuals with hepatitis C, especially young people, are more likely to die from their continued drug use than from their infection, new research shows. By contrast, with hepatitis B, liver-related causes of death dominate.

The findings, which appear in the September 9th issue of The Lancet, stem from a large community-based linkage study of causes of death after a diagnosis of hepatitis B or C.

The study included 39,109 people with hepatitis B, 75,834 with hepatitis C, and 2604 with hepatitis B and C coinfection. The subjects were reported to the state health department in New South Wales, Australia between 1990 and 2002.

The mortality rates for hepatitis B, C, and B/C coinfection were 3.2%, 5.3%, and 7.1%, respectively, lead author Janaki Amin and colleagues, from the University of New South Wales, report.

Compared with the general population, patients with hepatitis B, C, and B/C coinfection were 12.2-, 16.8-, and 32.9-times more likely to die from liver-related causes, the researchers found.

Drug-induced deaths were also significantly more common in the study group than in the general population, ranging from a 1.4-fold increased risk for hepatitis B infection to a 24.7-fold elevated risk for B/C coinfection.

As noted, patients with hepatitis C, either alone or combined with hepatitis B, were more likely to die from continued drug use than from liver-relate etiologies. This difference was most pronounced in female patients between 15 and 24 years of age, among whom drug-related causes of death were 56.9-times more common than liver-related ones.

The researchers "have accurately characterized the ravages of chronic hepatitis B and C in their community, which is undoubtedly a reflection of thousands of communities throughout the world," Dr. Eugene R. Schiff, from the University of Miami School of Medicine, comments in a related editorial.

"The challenge is early detection of these diseases with appropriate preventive measures as well as timely therapeutic intervention," Dr. Schiff adds.

Lancet 2006;368:896-897,938-945.