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. 2022 Feb 8:2022:2573545.
doi: 10.1155/2022/2573545. eCollection 2022.

Mortality among Alaska Native Adults with Confirmed Hepatitis C Virus Infection Compared with the General Population in Alaska, 1995-2016

Sara S Bressler  1 , Dana Bruden  1 , Leisha D Nolen  1 , Michael G Bruce  1 , Lisa Towshend-Bulson  2 , Philip Spradling  3 , Brian J McMahon  1   2
Affiliations

Mortality among Alaska Native Adults with Confirmed Hepatitis C Virus Infection Compared with the General Population in Alaska, 1995-2016

Sara S Bressler et al. Can J Gastroenterol Hepatol. .

Abstract

Background: Hepatitis C virus (HCV) infection incidence rates in the United States have increased since 2010 as a byproduct of the opioid crisis despite the introduction of direct-acting antiviral agents in 2013. HCV infection is associated with higher rates of liver-related and nonhepatic causes of death.

Methods: This study compared demographic characteristics and age-adjusted death rates from 1995 to 2016 among Alaska Native (AN) adults infected with HCV (AK-HepC) to rates among the AN and non-AN adult populations living in Alaska. Liver-related disease (LRD) and other disease-specific age-adjusted death rates were compared between the populations.

Results: The all-cause death rate among the AK-HepC cohort was 2.2- and 3.4-fold higher than AN and non-AN adults, respectively, and remained stable over time in all populations. The LRD death rate among the AK-HepC cohort was 18- and 11-fold higher than the non-AN and AN, respectively. The liver cancer rate among the AK-HepC cohort was 26-fold higher compared to the Alaska statewide population. The AK-HepC cohort had elevated rates of death associated with nonhepatic diseases with circulatory disease having the highest rate in all populations. Among liver cancer deaths in the AK-HepC cohort, 32% had HCV listed as a contributing cause of death on the death certificate.

Conclusions: Death rates in the AK-HepC cohort remained stable since 1995 and higher compared to the general population. People with HCV infection had an elevated risk for all-cause, liver-related, and nonhepatic causes of death. Hepatitis C infection may be underrepresented as a cause of mortality in the United States.

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Conflict of interest statement

The authors declare that there are no conflicts of interest.

Figures

Figure 1
Figure 1
Annual age-adjusted all-cause and liver-related death rates among the Alaska-hepatitis C cohort in Alaska, 1995–2016. †. †Trends are not significant among either group (P > 0.05).
Figure 2
Figure 2
Proportion of death category with hepatitis C virus infection listed as a contributing cause of death among the Alaska-hepatitis C cohort and Alaska Native and Nonnative-Alaskan adults in Alaska, 1995–2016.
See this image and copyright information in PMC

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