title: The growing contribution of hepatitis C virus infection to liver-related mortality in Scotland.
abstract: The large number of individuals in Scotland who became infected with the hepatitis C virus (HCV) in the 1970s and 1980s leads us to expect liver-related morbidity and mortality to increase in the coming years. We investigated the contribution of HCV to liver-related mortality in the period January 1991 to June 2006. The study population consisted of 26,861 individuals whose death record mentioned a liver-related cause (underlying or contributing). Record-linkage to the national HCV Diagnosis database supplied HCV-diagnosed status for the study population. The proportion diagnosed with HCV among people dying from a liver-related cause rose from 2.8% (1995-1997) to 4.4% (2004-June 2006); the largest increase occurred in those aged 35-44 years at death (7% to 17%). Among all deaths from a liver-related cause, an HCV-positive diagnosis was more likely in those who died in 2001 or later than those who died in 1995-1997 (2001-2003: odds ratio (OR)=1.4, 95% confidence interval (CI): 1.1-1.7; 2004-June 2006: 1.6, 1.3-2.0), and in those who died at under 55 compared with at least 55 years of age. HCV infection represents a significant, growing, public health burden in Scotland in terms of early deaths from liver disease.
authors.affiliation: Health Protection Scotland, Glasgow, United Kingdom. smcdonald4@nhs.net
authors.forename: S A
authors.initials: SA
authors.lastname: McDonald
authors.forename: S J
authors.initials: SJ
authors.lastname: Hutchinson
authors.forename: S M
authors.initials: SM
authors.lastname: Bird
authors.forename: C
authors.initials: C
authors.lastname: Robertson
authors.forename: P R
authors.initials: PR
authors.lastname: Mills
authors.forename: L
authors.initials: L
authors.lastname: Graham
authors.forename: J F
authors.initials: JF
authors.lastname: Dillon
authors.forename: D J
authors.initials: DJ
authors.lastname: Goldberg
mesh_terms: D000328:Adult; D016001:Confidence Intervals; D005260:Female; D016174:Hepacivirus / Q000302:isolation & purification*; D006526:Hepatitis C / Q000453:epidemiology / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D012606:Scotland / Q000453:epidemiology; D055815:Young Adult