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. 2019 Mar 5;68(6):956-963.
doi: 10.1093/cid/ciy598.

Mortality Among Patients With Chronic Hepatitis B Infection: The Chronic Hepatitis Cohort Study (CHeCS)

Danae Bixler  1 , Yuna Zhong  1 , Kathleen N Ly  1 , Anne C Moorman  1 , Philip R Spradling  1 , Eyasu H Teshale  1 , Loralee B Rupp  2 , Stuart C Gordon  2 , Joseph A Boscarino  3 , Mark A Schmidt  4 , Yihe G Daida  5 , Scott D Holmberg  1 ; CHeCS Investigators
Affiliations

Mortality Among Patients With Chronic Hepatitis B Infection: The Chronic Hepatitis Cohort Study (CHeCS)

Danae Bixler et al. Clin Infect Dis. .

Abstract

Background: According to death certificates, approximately 1800 persons die from hepatitis B annually in the United States; however, this figure may underestimate true mortality from chronic hepatitis B (CHB).

Methods: We analyzed data from CHB patients seen in the Chronic Hepatitis Cohort Study (CHeCS) between 1 January 2006 and 31 December 2013. We compared overall and cause-specific death rates and mean ages at death between CHeCS CHB decedents and U.S. decedents from the Multiple Cause of Death (MCOD) file.

Results: Of 4389 CHB patients followed for a mean of 5.38 years, 492 (11%) CHB patients died after a mean follow-up of 3.00 years. Compared to survivors, decedents were older, more likely to be White (40.6%), African-American (27.1%), or male (74.2%); and more likely to have had cirrhosis (59.8%), diabetes (27.2%), alcohol abuse (17.7%), hepatocellular carcinoma (17.5%), or a liver transplant (5.7%); whereas survivors were more likely to be Asian (48.8%; all P < .001). CHB patients died at an average age of 59.8 years-14 years younger than the general U.S. population-and at higher rates for all causes (relative risk [RR] = 1.85, 95% confidence interval [CI], 1.851-1.857) and liver-related causes (RR = 15.91, 95% CI, 15.81-16.01). Only 19% of CHB decedents and 40% of those dying of liver disease had hepatitis B reported on their death certificates.

Conclusions: Compared to the general population, CHB patients die at younger ages and higher rates from all causes and liver-related causes. Death certificates underrepresent the true mortality from CHB.

Keywords: cause of death; chronic hepatitis B; liver disease; mortality; risk factors.

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Conflict of interest statement

Potential conflicts of interest.

Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

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