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© Research
Publication : Journal of hepatology

Excess mortality rate associated with hepatitis C virus infection: A community-based cohort study in rural Egypt

Scientific Fields
Diseases
Organisms
Applications
Technique

Published in Journal of hepatology - 26 Feb 2016

Mostafa A, Shimakawa Y, Medhat A, Mikhail NN, Chesnais CB, Arafa N, Bakr I, El Hoseiny M, El-Daly M, Esmat G, Abdel-Hamid M, Mohamed MK, Fontanet A

Link to Pubmed [PMID] – 26921686

J. Hepatol. 2016 Jun;64(6):1240-6

BACKGROUND & AIMS: >80% of people chronically infected with hepatitis C virus (HCV) live in resource-limited countries, yet the excess mortality associated with HCV infection in these settings is poorly documented.

METHODS: Individuals were recruited from three villages in rural Egypt in 1997-2003 and their vital status was determined in 2008-2009. Mortality rates across the cohorts were compared according to HCV status: chronic HCV infection (anti-HCV antibody positive and HCV RNA positive), cleared HCV infection (anti-HCV antibody positive and HCV RNA negative) and never infected (anti-HCV antibody negative). Data related to cause of death was collected from a death registry in one village.

RESULTS: Among 18,111 survey participants enrolled in 1997-2003, 9.1% had chronic HCV infection, 5.5% had cleared HCV infection, and 85.4% had never been infected. After a mean time to follow-up of 8.6years, vital status was obtained for 16,282 (89.9%) participants. When compared to those who had never been infected with HCV in the same age groups, mortality rate ratios (MRR) of males with chronic HCV infection aged <35, 35-44, and 45-54years were 2.35 (95% CI 1.00-5.49), 2.87 (1.46-5.63), and 2.22 (1.29-3.81), respectively. No difference in mortality rate was seen in older males or in females. The all-cause mortality rate attributable to chronic HCV infection was 5.7% (95% CI: 1.0-10.1%), while liver-related mortality was 45.5% (11.3-66.4%).

CONCLUSIONS: Use of a highly potent new antiviral agent to treat all villagers with positive HCV RNA may reduce all-cause mortality rate by up to 5% and hepatic mortality by up to 40% in rural Egypt.

http://www.ncbi.nlm.nih.gov/pubmed/26921686