Author:
New York State Department of Health (APHA)
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Date Posted: Sat, March 03 2001, 7:39:03 PST
Hepatitis C Mortality and Complication Rates in New York Determined
New York State Department of Health epidemiologists recently reviewed and compiled the mortality and complication rates for hospital patients with hepatitis C (HepC) virus in Upstate New York.
A report of these findings was presented by P.F. Smith and associates at the 2000 International Conference on Emerging Infectious Diseases, held in July, 2000 in Atlanta, Georgia. The conference was hosted by the U.S. Centers for Disease Control and Prevention. The Smith et al. presentation was titled "Mortality and Chronic Complications Among Persons Dying with Hepatitis C, Upstate New York, 1997."
This review was performed by comparing patient hospitalization discharge records for cause of death with Upstate New York 1997 multiple cause of death records. Records for patients within New York City were omitted from the review.
"Their medical records were reviewed to verify the diagnosis of HepC, ascertain the presence of hepatitis-associated complications, and determine the risk factors for HepC," researchers said.
More than 500 records were initially obtained from hospitals, with 273 of those being officially included in the study. A total of 80 patients for which medical records were available had a diagnosis that mentioned hepatitis C. Approximately 60% of the 80 patients were male and of white race. The following complication rates were determined based on record review:
• Encephalopathy (43%)
• Cirrhosis (81%)
• Hepatocellular carcinoma (6%)
• Renal failure (59%)
• Gastrointestinal bleeding (31%)
Additional data showed some patients to be coinfected with human immunodeficiency virus (HIV) and hepatitis B virus (HBV) at rates of 19% and 21%, respectively.
The investigators determined that in at least 75 of the 80 cases, hepatitis C related complications were a cause of death.
Previous drug use and receipt of blood products were two risk factors for HCV infection identified by Smith et al., however, documentation was scarce in this area, so other risk factors could not be identified.
"Matching HepC hospitalization deaths with death certificates gave a minimal estimate of 491 deaths (4.5/100,000) with HepC in Upstate NY in 1997," Smith et al. reported.
Smith and associates concluded that their data were comparable to previously reported estimates for HCV mortality.
"Diagnosis of patients with HepC is important for appropriate counseling and care in order to decrease complications and mortality from HepC," they said.
The corresponding author for this study is P.F. Smith, New York State Department of Health, Division of Epidemiology, New York, USA.
Key points reported in this study are:
• The rate for hepatitis C virus related deaths is 4.5/100,000 persons in Upstate New York
• Renal failure, encephalopathy, and cirrhosis are some of the identified hepatitis C virus complications that lead to death
• Mortality and complications from hepatitis C virus infection can be prevented with proactive diagnostic and treatment efforts
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