1284. The Growing Burden of Mortality Associated with Viral Hepatitis in the United States, 1999-2007
Session: Poster Abstract Session: Viral Epidemiology
Saturday, October 22, 2011
Room: Poster Hall B1
  • Holmberg et al IDSA 2011 Poster 11_225905_Growing_Mortality PosterREVISED 2.pdf (607.0 kB)
  • Background: The increasing US health burden and mortality from viral hepatitis B and C are insufficiently appreciated.

    Methods: National multiple-cause mortlaity data for 1999-2007, about 21.8 million ecords, were examined for any mention of hepatitis B virus (HBV), hepatitis C virus (HCV), and, for comparison, HIV infection.  We assessed age-adjusted mortality rates, proportions of select sociodemographic characteristics, and potentially preventable co-morbidities in hepatitis B- and C-infected decedents in 2007.

    Results: From 1999-2007, the HBV-related death rate was almost constant, while deaths associated with HCV increased significantly (annual age-adjusted mortality rate change +0.18 deaths/100,000 per yr) to a total of 15,106 deaths in 2007; by comparison, HIV deaths declined to 12,734 deaths in 2007.  Of the HCV-related deaths, 73.4% occurred among persons aged 45-64 years.  Co-morbidities associated with increased odds of HCV-related mortality included: chronic liver disease (adjusted odds ratio [ORadj] 32.1); hepatitis B co-infection (ORadj 29.9), alcohol-related conditions (ORadj 4.6); and HIV co-infection (ORadj 1.8).  Like HCV, most deaths in HBV-infected persons occurred in those aged 45-64 years (59.4%).  Characteristics/factors increasing the odds of HBV-related death included: Asian/Pacific Islander identity (various models, ORadj 13.1-17.2); chronic liver disease (ORadj 34.4); HCV co-infection (ORadj 31.5); HIV coinfection (ORadj 4.0); and alcohol-related conditions (ORadj 3.7).

    Conclusion: Mortality associated with viral hepatitis was disproportionately high for middle-aged persons of all races, Asians/Pacific Islanders with hepatitis B, and all minorities with HCV.  By 2007 hepatitis C-associated deaths had overtaken HIV as a cause of mortality in the United States.  To achieve declines in mortality similar to those seen with HIV require new policy directions and commitment to detect and link infected persons to care and successful treatment.

    Subject Category: N. Hospital-acquired and surgical infections, infection control, and health outcomes including general public health and health services research

    Scott Holmberg, MD, MPH1,2, Kathleen Ly, MPH3, Monina Klevens, DDS, MPH4, Ruth Jiles, PhD, MPH, MS4, Jian Xing, PhD5 and John Ward, MD6, (1)Centers for Disease Prevention and Control, Atlanta, GA, (2)Division of Viral Hepatitis, Centers for Disease Prevention and Control, Atlanta, GA, (3)Division of Viral Hepatitis, CDC, Atlanta, GA, (4)Div Viral Hepatitis, CDC, Atlanta, GA, (5)Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, GA, (6)Division of Viral Hepatitis, Centers for Disease Control and Prevention/NCHHSTP, Atlanta, GA


    S. Holmberg, None

    K. Ly, None

    M. Klevens, None

    R. Jiles, None

    J. Xing, None

    J. Ward, None

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