Deaths Associated With Hepatitis C Virus Infection Among Residents in 50 States and the District of Columbia, 2016-2017

Kathleen N Ly; Arialdi M Miniño; Stephen J Liu; Henry Roberts; Elizabeth M Hughes; John W Ward; Ruth B Jiles

doi:10.1093/cid/ciz976

Deaths Associated With Hepatitis C Virus Infection Among Residents in 50 States and the District of Columbia, 2016-2017

Clin Infect Dis. 2020 Aug 22;71(5):1149-1160. doi: 10.1093/cid/ciz976.

Authors

Kathleen N Ly¹, Arialdi M Miniño², Stephen J Liu³, Henry Roberts¹, Elizabeth M Hughes¹, John W Ward⁴, Ruth B Jiles¹

Affiliations

¹ Division of Viral Hepatitis, National Center for Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome, Viral Hepatitis, Sexually Transmitted Disease, and Tuberculosis Prevention, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
² Division of Vital Statistics, National Center for Health Statistics, US Centers for Disease Control and Prevention, Hyattsville, Maryland, USA, Pittsburg, Pennsylvania, USA.
³ Graduate School of Public Health, University of Pittsburg, Pittsburg, Pennsylvania, USA.
⁴ Coalition for Global Hepatitis Elimination, The Task Force for Global Health, Decatur, Georgia, USA.

PMID: 31586173
DOI: 10.1093/cid/ciz976

Abstract

Background: Mortality associated with hepatitis C virus (HCV) has been well-documented nationally, but an examination across regions and jurisdictions may inform health-care planning.

Methods: To document HCV-associated deaths sub-nationally, we calculated age-adjusted, HCV-associated death rates and compared death rate ratios (DRRs) for 10 US regions, 50 states, and Washington, D.C., using the national rate and described rate changes between 2016 and 2017 to determine variability. We examined the mean age at HCV-associated death, and rates and proportions by sex, race/ethnicity, and birth year.

Results: In 2017, there were 17 253 HCV-associated deaths, representing 4.13 (95% confidence interval [CI], 4.07-4.20) deaths/100 000 standard population, in a significant, 6.56% rate decline from 4.42 in 2016. Age-adjusted death rates significantly surpassed the US rate for the following jurisdictions: Oklahoma; Washington, D.C.; Oregon; New Mexico; Louisiana; Texas; Colorado; California; Kentucky; Tennessee; Arizona; and Washington (DRRs, 2.87, 2.77, 2.24, 1.62, 1.57, 1.46, 1.36, 1.35, 1.35, 1.35, 1.32, and 1.32, respectively; P < .05). Death rates ranged from a low of 1.60 (95% CI, 1.07-2.29) in Maine to a high of 11.84 (95% CI, 10.82-12.85) in Oklahoma. Death rates were highest among non-Hispanic (non-H) American Indians/Alaska Natives and non-H Blacks, both nationally and regionally. The mean age at death was 61.4 years (range, 56.6 years in West Virginia to 64.1 years in Washington, D.C.), and 78.6% of those who died were born during 1945-1965.

Conclusions: In 2016-2017, the national HCV-associated mortality declined but rates remained high in the Western and Southern regions and Washington, D.C., and among non-H American Indians/Alaska Natives, non-H Blacks, and Baby Boomers. These data can inform local prevention and control programs to reduce the HCV mortality burden.

Keywords: hepatitis C; deaths; jurisdiction; mortality; region.

Published by Oxford University Press for the Infectious Diseases Society of America 2019.

Publication types

Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Arizona
Colorado
District of Columbia / epidemiology
Hepacivirus*
Hepatitis C* / epidemiology
Humans
Kentucky
Louisiana
Maine
Oregon
Tennessee
Texas
United States / epidemiology
Washington