Methods: ICD-10 codes in the MCOD ‘record axis’ fields were examined for hepatitis C and 59 other nationally notifiable (to CDC) infectious conditions. To calculate mortality rates in MCOD data, deaths associated with HCV infection and the other infectious conditions were divided by the US Census population for each year or, for CHeCS, by the numbers of HCV-infected persons in the cohort in each year.
Results: From 2003-2013, deaths with hepatitis C recorded on death certificates increased from 11,051 in 2003 to 19,368 in 2013 (Figure; Cochrane-Armitage trend test, p=0.01), while deaths associated with all 59 other notifiable infectious conditions decreased from 24,434 in 2003 to 18,002 in 2013 (Figure, trend, p=0.06). In 2012, the number of deaths associated with hepatitis C surpassed that with all 59 other notifiable infectious conditions. In 2013, 51.1% (n=9,899) of HCV-related deaths occurred among persons aged 55-64 years (mean age, 59.7 years). Declining mortality trends were observed in 11,000 HCV-infected persons in care in CHeCS.
Conclusion: Despite improving therapies, deaths from hepatitis C—mainly among persons aged 55-64 years-- continue to rise, indicating the poor penetrance of therapies to the 3 million Americans estimated to be infected with HCV. Moreover, since only 19% of HCV-infected patients who die have HCV listed anywhere on their death certificate, these data underestimate the problem.
Figure. Annual number of deaths from hepatitis C virus and 59 other nationally notifiable infectious conditions listed as multiple causes of death in the United States , 2003- 2013.
S. D. Holmberg,
J. Xing, None
E. Hughes, None
A. C. Moorman, None
R. Jiles, None