Division of Nephrology, Department of Internal Medicine, Chi Mei Hospital Chiali, Tainan, Taiwan.
Division of Hepato-Gastroenterology, Department of Internal Medicine, Chi Mei Hospital Liouying, Tainan, Taiwan.
PLoS One. 2024 Sep 9;19(9):e0309819. doi: 10.1371/journal.pone.0309819. eCollection 2024.
Hepatitis C virus (HCV) infection affects men and women differently, yet few studies have investigated sex differences in long-term mortality risk among the HCV-infected population. We conducted a population-based study to elucidate all-cause and cause-specific mortality among men and women with HCV infection.
The study population consisted of adult participants from the 1999-2018 National Health and Nutrition Examination Survey, including 945 HCV-infected and 44,637 non-HCV-infected individuals. HCV infection was defined as either HCV seropositivity or detectable HCV RNA. Participants were followed until the date of death or December 31, 2019, to determine survival status.
The HCV-infected population, both male and female, tended to be older, more likely to be Black, single, have lower income, lower BMI, higher prevalence of hypertension, and were more likely to be current smokers. During a median follow-up of 125.0 months, a total of 5,309 participants died, including 1,253 deaths from cardiovascular disease (CVD) and 1,319 deaths from cancer. The crude analysis showed that the risk of death from all causes and from cancer, but not from CVD, was higher in the HCV-infected population. After adjusting for potential confounders, we found that both HCV-infected men (HR 1.41, 95% CI 1.10-1.81) and women (HR 2.03, 95% CI 1.36-3.02) were equally at increased risk of all-cause mortality compared to their non-HCV infected counterparts (p for interaction > 0.05). The risk of cancer-related mortality was significantly increased in HCV-infected women (HR 2.14, 95% CI 1.01-4.53), but not in men, compared to non-HCV-infected counterparts. Among HCV-infected population, there was no difference in the risks of all-cause, CVD-related, or cancer-related death between men and women.
Both men and women with HCV infection had an increased risk of death from all causes compared to their non-HCV infected counterparts, but we did not observe a significant sex difference.
丙型肝炎病毒（HCV）感染对男性和女性的影响不同，但很少有研究调查 HCV 感染人群的长期死亡率的性别差异。我们进行了一项基于人群的研究，以阐明 HCV 感染男性和女性的全因和病因特异性死亡率。
研究人群包括 1999 年至 2018 年全国健康和营养检查调查的成年参与者，包括 945 例 HCV 感染和 44637 例非 HCV 感染个体。HCV 感染定义为 HCV 血清阳性或可检测到 HCV RNA。参与者随访至死亡或 2019 年 12 月 31 日，以确定生存状态。
HCV 感染人群（男性和女性）年龄较大，更有可能是黑人、单身、收入较低、BMI 较低、高血压患病率较高，且更有可能是当前吸烟者。在中位随访 125.0 个月期间，共有 5309 名参与者死亡，其中 1253 例死于心血管疾病（CVD），1319 例死于癌症。粗分析显示，HCV 感染人群的全因死亡风险以及癌症死亡风险（但 CVD 死亡风险无差异）更高。调整潜在混杂因素后，我们发现 HCV 感染男性（HR 1.41，95%CI 1.10-1.81）和女性（HR 2.03，95%CI 1.36-3.02）与非 HCV 感染人群相比，全因死亡率风险均增加（交互检验 p 值>0.05）。与非 HCV 感染人群相比，HCV 感染女性（HR 2.14，95%CI 1.01-4.53）癌症相关死亡率显著增加，但男性无此风险。在 HCV 感染人群中，男性和女性的全因、CVD 相关或癌症相关死亡风险无差异。
与非 HCV 感染人群相比，HCV 感染的男性和女性全因死亡风险均增加，但我们未观察到显著的性别差异。
