Open AccessImpact on mortality of being seropositive for hepatitis C virus antibodies among blood donors in Brazil: A twenty-year study
Author(s) -
Hélio Ranes de Menezes Filho,
Ana Luiza Bierrenbach,
Maria Ligia Damato Capuani,
Alfredo Mendrone,
Adèle Schwartz Benzaken,
Soraia Mafra Machado,
Marielena Vogel Saivish,
Éster Cerdeira Sabino,
Steven S. Witkin,
Maria Cássia Mendes-Corrêa
Publication year - 2019
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0226566
Subject(s) - medicine , death certificate , hazard ratio , hepatitis c virus , cohort , hepatitis c , cause of death , proportional hazards model , mortality rate , cohort study , retrospective cohort study , record linkage , immunology , population , virus , confidence interval , disease , environmental health
Hepatitis C virus (HCV) infection is a major health problem associated with considerable risk of mortality in different regions of the world. The purpose of this study was to investigate the contribution of HCV infection on all-cause and liver-related mortality, in a large cohort of blood donors in Brazil. Methods This is a retrospective cohort study of blood donors from 1994 to 2013, at Fundação Pró-Sangue—Hemocentro de São Paulo (FPS) . This cohort included 2,892 and 5,784 HCV antibody seropositive and seronegative donors, respectively. Records from the FPS database and the Mortality Information System (SIM: a national database in Brazil) were linked through a probabilistic record linkage (RL). Mortality outcomes were defined based on ICD-10 (10th International Statistical Classification of Diseases and Related Health Problems) codes listed as the cause of death on the death certificate. Hazard ratios (HRs) were estimated for outcomes using Cox multiple regression models. Results When all causes of death were considered, RL identified 209 deaths (7.2%) among seropositive blood donors and 190 (3.3%) among seronegative blood donors. Donors seropositive for HCV infection had a 2.5 times higher risk of death due to all causes (95% CI: 1.76–2.62; p<0.001). When only liver-related causes of death were considered, RL identified 73 deaths among seropositive blood donors and only 6 among seronegative blood donors. Donors seropositive for HCV infection had a 23.4 times higher risk of death due to liver related causes (95% CI: 10.2–53.9; p<0.001). Donors seropositive for HCV had a 29.5 (95%CI: 3.9–221.7), 2.8 (95% CI: 1.4–5.5) and a 1.9 (95% CI: 1.2–3.0) times higher risk of death due to hepatocellular carcinoma, infection or trauma, respectively, compared to seronegative donors. Conclusions All-cause and liver-related mortality rate was increased among blood donors seropositive for HCV compared with the mortality rate among seronegative blood donors. Our data confirms HCV as a relevant cause of death in Brazil and also suggest that interventions directed at following patients even after access to specific drug treatment are urgent and necessary.