Comparative Risk of Liver-Related Mortality From Chronic Hepatitis B Versus Chronic Hepatitis C Virus Infection
Year: 2012
Type: article
Abstract: BACKGROUND: It is not known whether chronic hepatitis B (CH-B) or chronic hepatitis C (CH-C) carries a greater risk of liver-related mortality. This study compared rates of liver-related mortality between these 2 groups in the Multicenter AIDS Cohort Study (MACS). METHODS: Six hundred eighty men with CH-B (n = 337) or CH-C (n = 343) at study entry into the MACS were prospectively followed to death, last follow-up visit, or 30 March 2010, whichever came first. Four hundred seventy-two (69.4%) of these men were infected with human immunodeficiency virus type 1 (HIV-1). Causes of death were obtained from death registry matching and death certificates. Liver-related and all-cause mortality rates (MRs) were compared between groups using Poisson regression and adjusted for potential confounders and competing risks. RESULTS: In 6728 person-years (PYs) of follow-up, there were 293 deaths from all causes (43.5 per 1000 PYs), of which 51 were liver-related (7.6 per 1000 PYs). The all-cause MR was similar between those with CH-B and CH-C; however, the liver-related MR was significantly higher in those with CH-B (9.6 per 1000 PYs; 95% confidence interval [CI], 6.9-13.2) than those with CH-C (5.0 per 1000 PYs; 95% CI, 3.0-8.4). In the HIV-infected subgroup, which had 46 (90.2%) of the liver-related deaths, the liver-related MR remained higher from CH-B after adjusting for potential confounders (incidence rate ratio, 2.2; P = .03) and competing risks (subhazard rate ratio, 2.4; P = .02). Furthermore, among HIV-infected subjects, CD4 cell counts <200 cells/mm(3) were associated with a 16.2-fold (95% CI, 6.1-42.8) increased risk of liver-related death compared with CD4 cell counts >350 cell/mm(3). CONCLUSIONS: Chronic hepatitis B carries a higher risk of death from liver disease than does CH-C, especially in HIV-infected men with greater immunosuppression.
Source: Clinical Infectious Diseases
DOI: 10.1093/cid/cis432
Authors: O. Falade-Nwulia, E. C. Seaberg, C. R. Rinaldo, S. Badri, M. Witt, C. L. Thio
Language: English
Topic: Hepatitis C virus research
Subfield: Hepatology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Funders: Northwestern University, Johns Hopkins University, University of Pittsburgh, Deutsches Krebsforschungszentrum, University of California, Los Angeles, Feinberg School of Medicine, Johns Hopkins Bloomberg School of Public Health, National Cancer Institute, National Institute of Allergy and Infectious Diseases, National Center for Research Resources
Awards: G141124744, G1540230653, G1648982045, G1705418768, G2072110039, G2088232294, G344188330, G359857122, G4142465102, Natural History of AIDS in Homosexual Men, G4330383484, G4698605015, G51363488, Center/Coordination, Analysis and Management/MACS, G536099884, G555535742, G5577046437, Multicenter AIDS Cohort Study, G714446084
OpenAlex ID: W2162821279