Viral Hepatitis

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Increased rate of death related to presence of viremia among hepatitis C virus antibody–positive subjects in a community-based cohort study†

  1. Hirofumi Uto1,‡,*,
  2. Sherri O. Stuver2,3,
  3. Katsuhiro Hayashi4,
  4. Kotaro Kumagai1,
  5. Fumisato Sasaki1,
  6. Shuji Kanmura1,
  7. Masatsugu Numata1,
  8. Akihiro Moriuchi1,
  9. Susumu Hasegawa1,
  10. Makoto Oketani1,
  11. Akio Ido1,
  12. Kazunori Kusumoto5,
  13. Satoru Hasuike5,
  14. Kenji Nagata5,
  15. Michinori Kohara6,
  16. Hirohito Tsubouchi1

Article first published online: 1 APR 2009

DOI: 10.1002/hep.23002

Issue

Hepatology

Hepatology

Volume 50, Issue 2, pages 393–399, August 2009

Additional Information

How to Cite

Uto, H., Stuver, S. O., Hayashi, K., Kumagai, K., Sasaki, F., Kanmura, S., Numata, M., Moriuchi, A., Hasegawa, S., Oketani, M., Ido, A., Kusumoto, K., Hasuike, S., Nagata, K., Kohara, M. and Tsubouchi, H. (2009), Increased rate of death related to presence of viremia among hepatitis C virus antibody–positive subjects in a community-based cohort study. Hepatology, 50: 393–399. doi: 10.1002/hep.23002

Author Information

  1. 1

    Department of Digestive and Life-style related Disease, Health Research Human and Environmental Sciences, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan

  2. 2

    Department of Epidemiology, Boston University School of Public Health, Boston, MA

  3. 3

    Department of Epidemiology, Harvard School of Public Health, Boston, MA

  4. 4

    Center for Medical Education, Faculty of Medicine, University of Miyazaki, Kiyotake, Japan

  5. 5

    Gastroenterology and Hematology, Faculty of Medicine, University of Miyazaki, Kiyotake, Japan

  6. 6

    Department of Microbiology and Cell Biology, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan

  1. ‡

    fax: (81) 99-264-3504

*Kagoshima University Graduate School of Medical and Dental Sciences, Department of Digestive Disease and Life-style related Disease Health Research, 8-35-1 Sakuragaoka, Kagoshima, Japan 890-8520

  1. †

    Potential conflict of interest: Nothing to report.

Publication History

  1. Issue published online: 29 JUL 2009
  2. Article first published online: 1 APR 2009
  3. Accepted manuscript online: 1 APR 2009 12:00AM EST
  4. Manuscript Accepted: 26 MAR 2009
  5. Manuscript Received: 13 JAN 2009

Funded by

  • United States National Institutes of Health. Grant Number: CA87982
  • Research on Hepatitis and Bovine Spongiform Encephalitis
  • Ministry of Health, Labour and Welfare of Japan
  • Miyazaki Prefecture Collaboration of Regional Entities for the Advancement of Technological Excellence (Japan Science and Technology Corp.)

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Abstract

The overall mortality of patients infected with hepatitis C virus (HCV) has not been fully elucidated. This study analyzed mortality in subjects positive for antibody to HCV (anti-HCV) in a community-based, prospective cohort study conducted in an HCV hyperendemic area of Japan. During a 10-year period beginning in 1995, 1125 anti–HCV-seropositive residents of Town C were enrolled into the study and were followed for mortality through 2005. Cause of death was assessed by death certificates. Subjects with detectable HCV core antigen (HCVcAg) or HCV RNA were considered as having hepatitis C viremia and were classified as HCV carriers; subjects who were negative for both HCVcAg and HCV RNA (i.e., viremia-negative) were considered as having had a prior HCV infection and were classified as HCV noncarriers. Among the anti–HCV-positive subjects included in the analysis, 758 (67.4%) were HCV carriers, and 367 were noncarriers. A total of 231 deaths occurred in these subjects over a mean follow-up of 8.2 years: 176 deaths in the HCV carrier group and 55 in the noncarrier group. The overall mortality rate was higher in HCV carriers than in noncarriers, adjusted for age and sex (hazard ratio, 1.53; 95% confidence interval, 1.13-2.07). Although liver-related deaths occurred more frequently among the HCV carriers (hazard ratio, 5.94; 95% confidence interval, 2.58-13.7), the rates of other causes of death did not differ between HCV carriers and noncarriers. Among HCV carriers, a higher level of HCVcAg (≥100 pg/mL) and persistently elevated alanine aminotransferase levels were important predictors of liver-related mortality. Conclusion: The presence of viremia increases the rate of mortality, primarily due to liver-related death, among anti–HCV-seropositive persons in Japan. (HEPATOLOGY 2009.)

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