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

被引:11
|
作者
Mostafa, Aya [1 ]
Shimakawa, Yusuke [2 ]
Medhat, Ahmed [3 ]
Mikhail, Nabiel N. [4 ]
Chesnais, Cedric B. [2 ,5 ]
Arafa, Naglaa [1 ]
Bakr, Iman [1 ]
El Hoseiny, Mostafa [1 ]
El-Daly, Mai [6 ,7 ]
Esmat, Gamal [8 ]
Abdel-Hamid, Mohamed [6 ,9 ]
Mohamed, Mostafa K. [1 ]
Fontanet, Arnaud [2 ,10 ]
机构
[1] Ain Shams Univ, Fac Med, Dept Commun Environm & Occupat Med, Cairo, Egypt
[2] Inst Pasteur, Unite Epidemiol Malad Emergentes, 25 Rue Docteur Roux, Paris, France
[3] Assiut Univ, Fac Med, Dept Gastroenterol & Trop Med, Assiut, Egypt
[4] Assiut Univ, South Egypt Canc Inst, Dept Biostat & Canc Epidemiol, Assiut, Egypt
[5] IRD, UMI 233, Montpellier, France
[6] Natl Hepatol & Trop Med Res Inst, Viral Hepatitis Res Lab, Cairo, Egypt
[7] Menoufia Univ, Natl Liver Inst, Menoufia, Egypt
[8] Cairo Univ, Fac Med, Endem Med Dept, Cairo, Egypt
[9] Minia Univ, Fac Med, Dept Microbiol & Immunol, Al Minya, Egypt
[10] Conservatoire Natl Arts & Metiers, Dept Informat & Epidemiol, Paris, France
基金
英国惠康基金;
关键词
Hepatitis C; Mortality; Cohort studies; Egypt; Africa; LIVER-RELATED MORTALITY; HCV INFECTION; RISK-FACTORS; NILE DELTA; NATURAL-HISTORY; CIRRHOSIS; DEATH; EPIDEMIOLOGY; TRANSMISSION; SPREAD;
D O I
10.1016/j.jhep.2016.02.033
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
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 8.6 years, 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 45-54 years 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. (C) 2016 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
引用
收藏
页码:1240 / 1246
页数:7
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