Mortality Rates in Patients With Chronic Hepatitis C and Cirrhosis Compared With the General Population: A Danish Cohort Study.
BACKGROUND
Knowledge about mortality rates (MRs) in patients with chronic hepatitis C (CHC) with cirrhosis is limited. This study aimed to estimate all-cause MRs among patients with CHC with or without cirrhosis in Denmark compared with the general population.


METHODS
Patients registered in the Danish Database for Hepatitis B and C with CHC and a liver fibrosis assessment were eligible for inclusion. Liver fibrosis was assessed by means of liver biopsy, transient elastography, and clinical cirrhosis. Up to 20 sex- and age-matched individuals per patient were identified in the general population. Data were extracted from nationwide registries.


RESULTS
A total of 3410 patients with CHC (1014 with cirrhosis), and 67 315 matched individuals were included. Adjusted MR ratios (MRRs) between patients with or without cirrhosis and their comparison cohorts were 5.64 (95% confidence interval [CI], 4.76-6.67) and 1.94 (1.55-2.42), respectively. Cirrhosis among patients was associated with an MRR of 4.03 (95% CI, 3.43-4.72). A cure for CHC was associated with an MRR of 0.64 (95% CI, 0.40-1.01) among cirrhotic patients and 2.33 (1.47-3.67) compared with the general population.


CONCLUSIONS
MRs were high among patients with CHC with or without cirrhosis compared with the general population. Curing CHC was associated with a reduction in MR among cirrhotic patients, but the MR remained higher than the general population.
Department of Infectious Diseases.
Sofie
S
Hallager
Odense University Hospital, Department of Infectious Diseases, and Clinical Institute, University of Southern Denmark.
Peer
P
Brehm Christensen
Clinical Research Center, and.
Steen
S
Ladelund
Departments of Hepatology.
Mette
M
Rye Clausen
Department of Infectious Diseases, Aarhus University Hospital, Skejby.
Alex
A
Lund Laursen
Department of Internal Medicine, Kolding Hospital.
Axel
A
Møller
Department of Gastroenterology, Copenhagen University Hospital, Herlev.
Poul
P
Schlicthting
Department of Internal Medicine, Zealand University Hospital, Køge, Denmark.
Lone
L
Galmstrup Madsen
Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, and.
Jan
J
Gerstoft
Department of Lung Medicine and Infectious Diseases, Nordsjællands Hospital, Hillerød.
Suzanne
S
Lunding
Department of Gastroenterology, Copenhagen University Hospital, Hvidovre.
Karin
K
Elmegaard Grønbæk
Clinical Biochemistry and Department of Gastroenterology, Section of Molecular Diagnostics, Aalborg University Hospital,Denmark.
Henrik
H
Bygum Krarup
Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen.
Nina
N
Weis
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000401:mortality*; D006801:Humans; D008103:Liver Cirrhosis / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chronic viral hepatitis; cirrhosis; cohort study; mortality; sustained virologic response