title: Mortality related to chronic hepatitis B and chronic hepatitis C in France: evidence for the role of HIV coinfection and alcohol consumption.
abstract: OBJECTIVE
  Mortality related to HCV and HBV infections was estimated in France.
  
  
  METHODS
  A random sample (n=999) of death certificates was obtained from all death certificates listing HBV, HCV, hepatitis, liver disease, possible complication of cirrhosis, bacterial infection, HIV, or transplantation (n=65,000) in France in 2001. Physicians who reported the deaths were sent a questionnaire to identify how many deaths were related to HBV/HCV infection. Completed forms were independently analyzed by a panel of hepatologists. Death rates were estimated according to national population census data.
  
  
  RESULTS
  Estimated annual number of deaths associated with HCV and HBV infection was 3618 and 1507, respectively (6.1 and 2.5 deaths per 100,000 inhabitants, respectively). Estimated number of deaths attributable to HCV or HBV infection was 2646 and 1327, respectively (4.5 and 2.2 deaths per 100,000 inhabitants, respectively). In the HCV infection group, 95 percent had cirrhosis; 33 percent had hepatocellular carcinoma (HCC). In the HBV infection group, 93 percent had cirrhosis; 35 percent had HCC. Eleven percent of deaths occurred in patients with HIV coinfection. Deaths related to HBV or HCV infection occurred at an earlier age in patients with a history of excessive alcohol consumption.
  
  
  CONCLUSIONS
  In France, 4000-5000 deaths related to HCV and HBV infection occurred in 2001. Alcohol consumption and HIV infection were important co-factors. These data emphasize the need for ongoing, efficient public health programs that include screening, management, and counseling for HCV- and HBV-infected individuals.
authors: Service d'Hépatologie & INSERM CRB3, University of Paris VII, AP-HP, CHU Beaujon, Clichy, France.
authors: Patrick
authors: P
authors: Marcellin
authors: Françoise
authors: F
authors: Pequignot
authors: Elisabeth
authors: E
authors: Delarocque-Astagneau
authors: Jean-Pierre
authors: JP
authors: Zarski
authors: Nathalie
authors: N
authors: Ganne
authors: Patrick
authors: P
authors: Hillon
authors: Denise
authors: D
authors: Antona
authors: Martine
authors: M
authors: Bovet
authors: Murielle
authors: M
authors: Mechain
authors: Tarik
authors: T
authors: Asselah
authors: Jean-Claude
authors: JC
authors: Desenclos
authors: Eric
authors: E
authors: Jougla
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking; D005260:Female; D005602:France / Q000453:epidemiology; D015658:HIV Infections / Q000150:complications / Q000401:mortality*; D019694:Hepatitis B, Chronic / Q000150:complications / Q000401:mortality*; D019698:Hepatitis C, Chronic / Q000150:complications / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged