November 10, 2011

Hepatitis C Surpasses HIV as Cause of Death in U.S.

It’s official. Chronic hepatitis C virus (HCV) infection is associated with more deaths than HIV infection, according to sobering new data presented by the U.S. Centers for Disease Control and Prevention (CDC) on Tuesday, November 8, at the 62nd annual meeting of the American Association for the Studies of Liver Diseases (AASLD) in San Francisco.

The discouraging findings, presented by Scott Holmberg, MD, MPH, chief of the CDC’s Division of Viral Hepatitis Epidemiology and Surveillance Branch, come from data involving 21.8 million deaths reported to the National Center for Health Statistics between 1999 and 2007. The only cases included in the analysis involved reports that specified HIV, AIDS, HCV or hepatitis B virus (HBV) infection as possible contributors to the deaths.

Encouragingly, death rates associated with chronic HBV infection—a major cause of liver failure and liver cancer—remained relatively flat between 1999 and 2007. In 2007, for example, about 1,800 U.S. residents died of HBV-related complications, which translated into less than one chronic hepatitis B-attributable death per 100,000 people in this country.

Death rates related to HIV infection continue to fall. Whereas HIV contributed to 6 per 100,000 deaths in 1999, the rate dropped to less than four per 100,000 deaths in 2007.

Hepatitis C–related deaths have increased sharply, Holmberg’s team reported. Whereas HCV contributed to roughly 3 per 100,000 deaths in 1999, the HCV-related death rate exceeded 4 per 100,000 people in the United States by 2007.

With respect to crude numbers, roughly 12,700 HIV-related deaths were reported to the National Center for Health Statistics in 2007. More than 15,000 HCV-related deaths were reported to the center that year. 

Most viral hepatitis deaths occurred in people in the prime of their lives. About 59 percent of people who died of complications related to hepatitis B were between the ages of 45 and 64. The impact of chronic hepatitis C was even more substantial—roughly 73 percent of the deaths related to HCV were in baby boomers.

Not surprisingly, death rates were highest among certain populations. For example, people coinfected with both HBV and HCV faced a 30-fold increase in the risk of death from liver disease or related complications. Alcohol abuse was associated with a four-fold increase in the risk of death. Coinfection with HIV nearly doubled the risk of death from HBV-related complications and quadrupled the risk of death from HCV-associated liver disease.

“[Achieving] declines in mortality similar to those seen with HIV,” Holmberg’s group concluded, “will require new policy directions and commitment to detect and link infectious persons to care and successful treatment.”

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Previous Comments:

John, NYC, 2012-01-31 13:51:47
I failed Interferon/Ribivirin after 12 weeks, it took me over a year to recover from the side effects. Selzentry is the HIV Entry Inhibitor now on trial to hopefully hault or reverse inflammation in the liver. I started this trial January 2012, but I'm about to be excluded because my enzymes went too high. Boceprevir/Telaprevir are the new drugs approved for HCV but are used in combination to the harsh Interferon/Ribiviron treatment and not often compatible with HIV. I'm running out of options..

M.A.L., L.A, 2011-12-25 19:13:58
I am so thankful for the Universe for allowing me to continue to breath. I was dx in the acute phase which causes symptoms - dark urine, pale bile, and vomiting. Then it quietly went away. I was infected by my partner. I was on the Hep C tx. for 8 months. It became mentally and physically overwhelming, I stopped. 90 days later, I took a Hep C test it was (-) and I continue to check it because it can come back. Sadly, con-infection life expectancy is only 6 -8 years.

Brian, Philadelphia, 2011-11-20 23:46:10
Ed - talk to your doctor again. My old doctor (PA really) kept saying there was incompatibility with my meds and that there is a new oral regimen coming out in 2yrs (which means 5 the way the FDA works). I tried the interferon/ribavirin combo and it didn't work. We waited another year for the new HepC protease inhibitor and then he said it had only been tested with a few HIV meds. I asked him to switch mine and he wouldn't. So I switched... doctors that is. Now I'm on the HIV meds to treat HepC.

craig, houston, 2011-11-18 15:30:53
There is a cure for hep c. it is not always successful, but, if you have the resources, is worth a try. I did a year of pegalated interferon with ribavirin and was successfully cured. it was one of the worst years of my life, but i would do it again. i was coinfected and did not have a major impact on my numbers. I was also infected with hvb (in spite of having the vaccine) and through a combination of epivir (nrti) and baraclude (pi) the hpv has been undetectable for years. i'm 57.

Brad, , 2011-11-18 12:55:45
I just finished my immunization program for HepA and HepB yesterday. It involves injections three times over a period of six months. My health insurance paid for it and encouraged me to get it. I asked and they told me the cost to pay for it yourself is about $300.00

Ann, , 2011-11-18 08:42:10
at Simon - make sure you are up-to-date with your hep A and hep B vaccinations. There is no vaccination for hep C. Do not share needles when injecting street drugs or steroids. Do not share straws when snorting drugs. There is increasing evidence that hep C can be transmitted during anal intercourse, so use condoms with those whose hep C status you do not know. Only get piercings or tattoos from places who strictly adhere to universal precautions. Be well!

Pierre Crawley, Lynbrook, 2011-11-16 23:49:13
I have chronic Hep C and HIV+. My last biopsy stated I had fibrosis. Grade 1. I have been treated with Pegasys in 2004.But after 3 months with no improvement, My Dr. stopped treatment. So we were looking forward to the new treatment that came out this year. And then I was told that the new Hep c therapy interfered with HIV meds. And a change of exposing me to opportunistic infections. Please explain to me what is the real deal. And is there anything out there that could help me?

Ed, Ohio, 2011-11-16 20:03:08
Based on my understanding, and I am not a doctor, but when I was with a friend who was visiting his doctor she told us that that one can have the virus and the virus can be dormant. I do know that Alcohol or any other type of stress on the liver could possibly trigger that virus to an active state. My suggestion is to ask your doctor point blank with any concerns that you may have.

thomas buehner md, palm springs, 2011-11-16 17:06:03
In a pt with stable hiv on meds viral load undetectable, and hcv genoptype 1 with viral load 800,000, nl lfts, no cirhosis on bx. what is your recomended treatment regime and for how long? Now in same pt but with genotype 2 or 3 hepc. What is your recommended treatment and for how long?

Simon Katz, New York, 2011-11-16 14:34:50
Is there anything a POZ person can do, besides not drinking alcohol that can help prevent developing Hepatitis? Anyone?