Wise Matthew, Bialek Stephanie, Finelli Lyn, Bell Beth P, Sorvillo Frank
Department of Epidemiology, School of Public Health, University of California, Los Angeles, CA 90095-1772, USA.
Hepatology. 2008 Apr;47(4):1128-35. doi: 10.1002/hep.22165.
The disease burden and mortality from hepatitis C are predicted to increase in the United States as the number of persons with long-standing chronic infection grows. We analyzed hepatitis C mortality rates derived from US Census and multiple-cause-of-death data for 1995-2004. Deaths were considered hepatitis C-related if: (1) hepatitis C was the underlying cause of death, (2) chronic liver disease was the underlying cause and hepatitis C was a contributing cause, or (3) human immunodeficiency virus was the underlying cause and chronic liver disease and hepatitis C were contributing causes. A total of 56,409 hepatitis C-related deaths were identified. Mortality rates increased 123% during the study period (1.09 per 100,000 persons to 2.44 per 100,000), but average annual increases were smaller during 2000-2004 than 1995-1999. After peaking in 2002 (2.57 per 100,000), overall rates declined slightly, but continued to increase among persons aged 55-64 years. Overall increases were greater among males (144%) than females (81%) and among non-Hispanic blacks (170%) and Native Americans (241%) compared to non-Hispanic whites (124%) and Hispanics (84%). The 7,427 hepatitis C deaths in 2004 (mean age: 55 years), corresponded to 148,611 years of potential life lost. The highest mortality rates in 2004 were observed among males, persons aged 45-54 and 55-64 years, Hispanics, non-Hispanic blacks, and non-Hispanic Native American/Alaska Natives.
Overall, hepatitis C mortality has increased substantially since 1995. Despite small declines in recent years, rates have continued to increase among persons aged 55-64 years. Hepatitis C is an important cause of premature mortality.
随着长期慢性感染丙型肝炎病毒的人数增加，预计美国丙型肝炎的疾病负担和死亡率将会上升。我们分析了1995 - 2004年美国人口普查数据以及多死因数据中的丙型肝炎死亡率。若符合以下情况，则死亡被视为与丙型肝炎相关：（1）丙型肝炎是根本死因；（2）慢性肝病是根本死因且丙型肝炎是促成死因；或（3）人类免疫缺陷病毒是根本死因且慢性肝病和丙型肝炎是促成死因。共确定了56409例与丙型肝炎相关的死亡病例。在研究期间，死亡率上升了123%（从每10万人1.09例升至每10万人2.44例），但2000 - 2004年期间的年均增长率低于1995 - 1999年。在2002年达到峰值（每10万人2.57例）后，总体死亡率略有下降，但在55 - 64岁人群中继续上升。总体而言，男性（144%）的死亡率增长幅度大于女性（81%），非西班牙裔黑人（170%）和美国原住民（241%）的死亡率增长幅度大于非西班牙裔白人（124%）和西班牙裔（84%）。2004年有7427例丙型肝炎死亡病例（平均年龄：55岁），相当于148611年的潜在寿命损失。2004年死亡率最高的人群为男性、45 - 54岁和55 - 64岁人群、西班牙裔、非西班牙裔黑人以及非西班牙裔美国原住民/阿拉斯加原住民。
总体而言，自1995年以来丙型肝炎死亡率大幅上升。尽管近年来略有下降，但55 - 64岁人群的死亡率仍在继续上升。丙型肝炎是过早死亡的一个重要原因。
