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. 2008 Mar 15;167(6):743-50.
doi: 10.1093/aje/kwm370. Epub 2008 Jan 17.

Increased all-cause, liver, and cardiac mortality among hepatitis C virus-seropositive blood donors

Anne M Guiltinan  1 , Zhanna Kaidarova, Brian Custer, Jennie Orland, Angela Strollo, Sherri Cyrus, Michael P Busch, Edward L Murphy
Affiliations

Increased all-cause, liver, and cardiac mortality among hepatitis C virus-seropositive blood donors

Anne M Guiltinan et al. Am J Epidemiol. .

Abstract

Hospital-based studies suggest that hepatitis C virus (HCV) infection causes frequent cirrhosis, hepatocellular carcinoma, and mortality, but epidemiologic studies have shown less morbidity and mortality. The authors performed a retrospective cohort study of 10,259 recombinant immunoblot assay-confirmed, HCV antibody-positive (HCV+), allogeneic blood donors from 1991 to 2002 and 10,259 HCV antibody-negative (HCV-) donors matched for year of donation, age, gender, and Zone Improvement Plan Code (ZIP Code). Vital status through 2003 was obtained from the US National Death Index, and hazard ratios with 95% confidence intervals were calculated by survival analysis. After a mean follow-up of 7.7 years, there were 601 (2.92%) deaths: 453 HCV+ and 148 HCV- (hazard ratio (HR) = 3.13, 95% confidence interval (CI): 2.60, 3.76). Excess mortality in the HCV+ group was greatest in liver-related (HR = 45.99, 95% CI: 11.32, 186.74), drug- or alcohol-related (HR = 10.81, 95% CI: 4.68, 24.96), and trauma/suicide (HR = 2.99, 95% CI: 2.05, 4.36) causes. There was also an unexpected increase in cardiovascular mortality among the HCV+ donors (HR = 2.21, 95% CI: 1.41, 3.46). HCV infection is associated with a significant, threefold increase in overall mortality among former blood donors, including significantly increased mortality from liver and cardiovascular causes. High rates of mortality from drug/alcohol and trauma/suicide causes are likely due to lifestyle factors and may be at least partially preventable.

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Figures

FIGURE 1
FIGURE 1
Hepatitis C virus-seropositive blood donors included in the cohort, by state of residence, United States, 1991–2003. Each dot represents one donor but does not reflect his/her location within the state. Two-letter abbreviations represent US Postal Service official state abbreviations.
FIGURE 2
FIGURE 2
Age-specific survival by hepatitis C virus (HCV) status, all causes of death, United States, 1991–2003. Log-rank p < 0.0001 for lower survival in the hepatitis C virus-positive group.
FIGURE 3
FIGURE 3
Age-specific survival by hepatitis C virus (HCV) status and cause-specific mortality: liver disease (including liver cancer) (A), cardiovascular causes (B), trauma and suicide (C), and cancer (excluding liver cancer) (D), United States, 1991–2003.
See this image and copyright information in PMC

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