Hepatitis C virus infection and risk of liver-related and non-liver-related deaths : a population-based cohort study in Naples, southern Italy
BACKGROUND: Hepatitis C virus (HCV) infection represents a global health issue with severe implications on morbidity and mortality. This study aimed to evaluate the impact of HCV infection on all-cause, liver-related, and non-liver-related mortality in a population living in an area with a high prevalence of HCV infection before the advent of Direct-Acting Antiviral (DAA) therapies, and to identify factors associated with cause-specific mortality among HCV-infected individuals.
METHODS: We conducted a cohort study on 4492 individuals enrolled between 2003 and 2006 in a population-based seroprevalence survey on viral hepatitis infections in the province of Naples, southern Italy. Study participants provided serum for antibodies to HCV (anti-HCV) and HCV RNA testing. Information on vital status to December 2017 and cause of death were retrieved through record-linkage with the mortality database. Hazard ratios (HRs) for cause-specific mortality and 95% confidence intervals (CIs) were estimated using Fine-Grey regression models.
RESULTS: Out of 626 deceased people, 20 (3.2%) died from non-natural causes, 56 (8.9%) from liver-related conditions, 550 (87.9%) from non-liver-related causes. Anti-HCV positive people were at higher risk of death from all causes (HR = 1.38, 95% CI: 1.12-1.70) and liver-related causes (HR = 5.90, 95% CI: 3.00-11.59) than anti-HCV negative ones. Individuals with chronic HCV infection reported an elevated risk of death due to liver-related conditions (HR = 6.61, 95% CI: 3.29-13.27) and to any cause (HR = 1.51, 95% CI: 1.18-1.94). The death risk of anti-HCV seropositive people with negative HCV RNA was similar to that of anti-HCV seronegative ones. Among anti-HCV positive people, liver-related mortality was associated with a high FIB-4 index score (HR = 39.96, 95% CI: 4.73-337.54).
CONCLUSIONS: These findings show the detrimental impact of HCV infection on all-cause mortality and, particularly, liver-related mortality. This effect emerged among individuals with chronic infection while those with cleared infection had the same risk of uninfected ones. These results underline the need to identify through screening all people with chronic HCV infection notably in areas with a high prevalence of HCV infection, and promptly provide them with DAAs treatment to achieve progressive HCV elimination and reduce HCV-related mortality.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:21 |
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| Enthalten in: |
BMC infectious diseases - 21(2021), 1 vom: 08. Juli, Seite 667 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Piselli, Pierluca [VerfasserIn] |
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| Links: |
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| Themen: |
Cohort study |
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| Anmerkungen: |
Date Completed 15.07.2021 Date Revised 15.07.2021 published: Electronic Citation Status MEDLINE |
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| doi: |
10.1186/s12879-021-06336-9 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM327841796 |
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| 100 | 1 | |a Piselli, Pierluca |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Hepatitis C virus infection and risk of liver-related and non-liver-related deaths |b a population-based cohort study in Naples, southern Italy |
| 264 | 1 | |c 2021 | |
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| 500 | |a Date Completed 15.07.2021 | ||
| 500 | |a Date Revised 15.07.2021 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: Hepatitis C virus (HCV) infection represents a global health issue with severe implications on morbidity and mortality. This study aimed to evaluate the impact of HCV infection on all-cause, liver-related, and non-liver-related mortality in a population living in an area with a high prevalence of HCV infection before the advent of Direct-Acting Antiviral (DAA) therapies, and to identify factors associated with cause-specific mortality among HCV-infected individuals | ||
| 520 | |a METHODS: We conducted a cohort study on 4492 individuals enrolled between 2003 and 2006 in a population-based seroprevalence survey on viral hepatitis infections in the province of Naples, southern Italy. Study participants provided serum for antibodies to HCV (anti-HCV) and HCV RNA testing. Information on vital status to December 2017 and cause of death were retrieved through record-linkage with the mortality database. Hazard ratios (HRs) for cause-specific mortality and 95% confidence intervals (CIs) were estimated using Fine-Grey regression models | ||
| 520 | |a RESULTS: Out of 626 deceased people, 20 (3.2%) died from non-natural causes, 56 (8.9%) from liver-related conditions, 550 (87.9%) from non-liver-related causes. Anti-HCV positive people were at higher risk of death from all causes (HR = 1.38, 95% CI: 1.12-1.70) and liver-related causes (HR = 5.90, 95% CI: 3.00-11.59) than anti-HCV negative ones. Individuals with chronic HCV infection reported an elevated risk of death due to liver-related conditions (HR = 6.61, 95% CI: 3.29-13.27) and to any cause (HR = 1.51, 95% CI: 1.18-1.94). The death risk of anti-HCV seropositive people with negative HCV RNA was similar to that of anti-HCV seronegative ones. Among anti-HCV positive people, liver-related mortality was associated with a high FIB-4 index score (HR = 39.96, 95% CI: 4.73-337.54) | ||
| 520 | |a CONCLUSIONS: These findings show the detrimental impact of HCV infection on all-cause mortality and, particularly, liver-related mortality. This effect emerged among individuals with chronic infection while those with cleared infection had the same risk of uninfected ones. These results underline the need to identify through screening all people with chronic HCV infection notably in areas with a high prevalence of HCV infection, and promptly provide them with DAAs treatment to achieve progressive HCV elimination and reduce HCV-related mortality | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Cohort study | |
| 650 | 4 | |a Hepatitis C virus | |
| 650 | 4 | |a Liver disease | |
| 650 | 4 | |a Mortality | |
| 650 | 4 | |a Southern Italy | |
| 650 | 7 | |a Hepatitis C Antibodies |2 NLM | |
| 650 | 7 | |a RNA, Viral |2 NLM | |
| 700 | 1 | |a Serraino, Diego |e verfasserin |4 aut | |
| 700 | 1 | |a Fusco, Mario |e verfasserin |4 aut | |
| 700 | 1 | |a Girardi, Enrico |e verfasserin |4 aut | |
| 700 | 1 | |a Pirozzi, Angelo |e verfasserin |4 aut | |
| 700 | 1 | |a Toffolutti, Federica |e verfasserin |4 aut | |
| 700 | 1 | |a Cimaglia, Claudia |e verfasserin |4 aut | |
| 700 | 1 | |a Taborelli, Martina |e verfasserin |4 aut | |
| 700 | 0 | |a Collaborating Study Group |e verfasserin |4 aut | |
| 700 | 1 | |a Capobianchi, Mariarosaria |e investigator |4 oth | |
| 700 | 1 | |a Carletti, Fabrizio |e investigator |4 oth | |
| 700 | 1 | |a Garbuglia, Anna R |e investigator |4 oth | |
| 700 | 1 | |a Ippolito, Giuseppe |e investigator |4 oth | |
| 700 | 1 | |a Scognamiglio, Paola |e investigator |4 oth | |
| 700 | 1 | |a Di Cicco, Pietro |e investigator |4 oth | |
| 700 | 1 | |a Gigli, Letizia |e investigator |4 oth | |
| 700 | 1 | |a Russospena, Silvana |e investigator |4 oth | |
| 700 | 1 | |a Palombino, Raffaele |e investigator |4 oth | |
| 700 | 1 | |a Panato, Chiara |e investigator |4 oth | |
| 700 | 1 | |a Mattioli, Veronica |e investigator |4 oth | |
| 700 | 1 | |a Dal Maso, Luigino |e investigator |4 oth | |
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