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

作者：Danae Bixler, Yuna Zhong, Kathleen N. Ly, Anne C. Moorman, Philip R. Spradling, Eyasu H. Teshale, Loralee B. Rupp, Stuart C. Gordon, Joseph A. Boscarino, Mark A. Schmidt, Yihe G. Daida, Scott D. Holmberg, CHeCS Investigators, Scott D. Holmberg, Eyasu H. Teshale, Philip R. Spradling, Anne C Moorman, Jian Xing, Yuna Zhong, Stuart C Gordon, David R Nerenz, Mei Lu, Lois Lamerato, Jia Li, Loralee B. Rupp, Nonna Akkerman, Talan Zhang, Sheri Trudeau, Yueren Zhou, Kuan-Han Wu, Joseph A. Boscarino, Zahra Daar, Robert E. Smith, Yihe G. Daida, Connie Mah Trinacty, Jonathan W Lai, Carmen P. Wong, Mark A. Schmidt, Judy Donald · 发表于：Clinical Infectious Diseases · 年份：2018 · DOI：10.1093/cid/ciy598 · 被引用次数：63 · 研究领域：Hepatitis B Virus Studies、Hepatitis C virus research、Hepatitis Viruses Studies and Epidemiology

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 live...