title: Increased rate of death related to presence of viremia among hepatitis C virus antibody-positive subjects in a community-based cohort study.
abstract: The overall mortality of patients infected with hepatitis C virus (HCV) has not been fully elucidated. This study analyzed mortality in subjects positive for antibody to HCV (anti-HCV) in a community-based, prospective cohort study conducted in an HCV hyperendemic area of Japan. During a 10-year period beginning in 1995, 1125 anti-HCV-seropositive residents of Town C were enrolled into the study and were followed for mortality through 2005. Cause of death was assessed by death certificates. Subjects with detectable HCV core antigen (HCVcAg) or HCV RNA were considered as having hepatitis C viremia and were classified as HCV carriers; subjects who were negative for both HCVcAg and HCV RNA (i.e., viremia-negative) were considered as having had a prior HCV infection and were classified as HCV noncarriers. Among the anti-HCV-positive subjects included in the analysis, 758 (67.4%) were HCV carriers, and 367 were noncarriers. A total of 231 deaths occurred in these subjects over a mean follow-up of 8.2 years: 176 deaths in the HCV carrier group and 55 in the noncarrier group. The overall mortality rate was higher in HCV carriers than in noncarriers, adjusted for age and sex (hazard ratio, 1.53; 95% confidence interval, 1.13-2.07). Although liver-related deaths occurred more frequently among the HCV carriers (hazard ratio, 5.94; 95% confidence interval, 2.58-13.7), the rates of other causes of death did not differ between HCV carriers and noncarriers. Among HCV carriers, a higher level of HCVcAg (>or=100 pg/mL) and persistently elevated alanine aminotransferase levels were important predictors of liver-related mortality.
  
  
  CONCLUSIONS
  The presence of viremia increases the rate of mortality, primarily due to liver-related death, among anti-HCV-seropositive persons in Japan.
authors: Department of Digestive and Life-style related Disease, Health Research Human and Environmental Sciences, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan. hirouto@m2.kufm.kagoshima-u.ac.jp
authors: Hirofumi
authors: H
authors: Uto
authors: Sherri O
authors: SO
authors: Stuver
authors: Katsuhiro
authors: K
authors: Hayashi
authors: Kotaro
authors: K
authors: Kumagai
authors: Fumisato
authors: F
authors: Sasaki
authors: Shuji
authors: S
authors: Kanmura
authors: Masatsugu
authors: M
authors: Numata
authors: Akihiro
authors: A
authors: Moriuchi
authors: Susumu
authors: S
authors: Hasegawa
authors: Makoto
authors: M
authors: Oketani
authors: Akio
authors: A
authors: Ido
authors: Kazunori
authors: K
authors: Kusumoto
authors: Satoru
authors: S
authors: Hasuike
authors: Kenji
authors: K
authors: Nagata
authors: Michinori
authors: M
authors: Kohara
authors: Hirohito
authors: H
authors: Tsubouchi
mesh_terms: D000368:Aged; D002353:Carrier State / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D018937:Hepatitis C Antibodies / Q000097:blood; D019698:Hepatitis C, Chronic / Q000097:blood / Q000401:mortality* / Q000821:virology; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014766:Viremia / Q000401:mortality*
chemical_list: D018937:Hepatitis C Antibodies