Changing trends in hepatitis C-related mortality in the United States, 1995-2004.
The disease burden and mortality from hepatitis C are predicted to increase in the United States as the number of persons with long-standing chronic infection grows. We analyzed hepatitis C mortality rates derived from US Census and multiple-cause-of-death data for 1995-2004. Deaths were considered hepatitis C-related if: (1) hepatitis C was the underlying cause of death, (2) chronic liver disease was the underlying cause and hepatitis C was a contributing cause, or (3) human immunodeficiency virus was the underlying cause and chronic liver disease and hepatitis C were contributing causes. A total of 56,409 hepatitis C-related deaths were identified. Mortality rates increased 123% during the study period (1.09 per 100,000 persons to 2.44 per 100,000), but average annual increases were smaller during 2000-2004 than 1995-1999. After peaking in 2002 (2.57 per 100,000), overall rates declined slightly, but continued to increase among persons aged 55-64 years. Overall increases were greater among males (144%) than females (81%) and among non-Hispanic blacks (170%) and Native Americans (241%) compared to non-Hispanic whites (124%) and Hispanics (84%). The 7,427 hepatitis C deaths in 2004 (mean age: 55 years), corresponded to 148,611 years of potential life lost. The highest mortality rates in 2004 were observed among males, persons aged 45-54 and 55-64 years, Hispanics, non-Hispanic blacks, and non-Hispanic Native American/Alaska Natives.


CONCLUSIONS
Overall, hepatitis C mortality has increased substantially since 1995. Despite small declines in recent years, rates have continued to increase among persons aged 55-64 years. Hepatitis C is an important cause of premature mortality.
Wise
Matthew
M
Department of Epidemiology, School of Public Health, University of California, Los Angeles, CA 90095-1772, USA. mawise@ph.lacounty.gov
Bialek
Stephanie
S
Finelli
Lyn
L
Bell
Beth P
BP
Sorvillo
Frank
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006526:Hepatitis C / Q000208:ethnology / Q000401:mortality*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D014481:United States / Q000453:epidemiology