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Changing trends in complications of chronic hepatitis C
Author(s) -
Lu Mei,
Li Jia,
Rupp Loralee B.,
Zhou Yueren,
Holmberg Scott D.,
Moorman Anne C.,
Spradling Philip R.,
Teshale Eyasu H.,
Boscarino Joseph A.,
Daida Yihe G.,
Schmidt Mark A.,
Trudeau Sheri,
Gordon Stuart C.
Publication year - 2018
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.13501
Subject(s) - medicine , cirrhosis , demographics , mortality rate , incidence (geometry) , demography , cohort , chronic hepatitis , hepatitis c , gastroenterology , virus , immunology , physics , sociology , optics
Background & Aims Chronic hepatitis C virus ( HCV )‐related complications have increased over the past decade. Methods We used join‐point regression modelling to investigate trends in these complications from 2006 to 2015, and the impact of demographics on these trends. Using data from the Chronic Hepatitis Cohort Study ( CH e CS ), we identified points at which the trend significantly changed, and estimated the annual percent change ( APC ) in rates of cirrhosis, decompensated cirrhosis and all‐cause mortality, adjusted by race, sex and age. Results Among 11,167 adults with chronic HCV infection, prevalence of cirrhosis increased from 20.8% to 27.6% from 2006 to 2015, with adjusted annual percentage change ( aAPC ) of 1.2 ( p <. 01). Although incidence of all‐cause mortality increased from 1.8% in 2006 to 2.9% in 2015, a join‐point was identified at 2010, with aAPC s of 9.6 before (2006 < 2010; p < .01) and −5.2 after (2010 ≤ 2015; p < .01), indicating a decrease in mortality from 2010 and onward. Likewise, overall prevalence of decompensated cirrhosis increased from 9.3% in 2006 to 10.4% in 2015, but this increase was confined to patients 60 or older ( aAPC = 1.5; p = .023). Asian American and Black/African American patients demonstrated significantly higher rates of cirrhosis than White patients, while older patients and men demonstrated higher rates of cirrhosis and mortality. Conclusions Although cirrhosis and mortality among HCV ‐infected patients in the US have increased over the past decade, all‐cause mortality has decreased in recent years.