慢性乙型肝炎（CHB）感染患者的死亡率：慢性肝炎队列研究

StephenW

Clin Infect Dis. 2018 Jul 28. doi: 10.1093/cid/ciy598. [Epub ahead of print]
Mortality among Patients with Chronic Hepatitis B (CHB) Infection: the Chronic Hepatitis Cohort Study (CHeCS).
Bixler D1, Zhong Y1, Ly KN1, Moorman AC1, Spradling PR1, Teshale EH1, Rupp L LB2, Gordon SC2, Boscarino JA3, Schmidt MA4, Daida YG5, Holmberg SD1; CHeCS Investigators.
Author information

1
    Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia.
2
    Henry Ford Health System, Detroit Michigan.
3
    Geisinger Health System, Danville, Pennsylvania.
4
    Kaiser Permanente-Northwest, Portland, Oregon.
5
    Kaiser Permanente-Hawaii, Honolulu.

Abstract
Background:

According to death certificates, approximately 1800 persons die from hepatitis B annually in the United States (US); however, this figure may underestimate the true mortality from chronic hepatitis B (CHB).
Methods:

We analyzed data from CHB patients seen in the Chronic Hepatitis Cohort Study (CHeCS) between January 1, 2006 and December 31, 2013. We compared overall and cause-specific death rates and mean age at death between CHeCS CHB decedents and US decedents from the multiple cause of death (MCOD) file.
Results:

A total of 4389 CHB patients were followed for a mean of 5.38 years through December 31, 2014; 492 (11%) CHB patients died after a mean follow-up of 3.00 years. Compared to survivors, decedents were older, more likely to be White (40.6%), African-American (27.1%) or male (74.2%), and more likely to have cirrhosis (59.8%), diabetes (27.2%), alcohol abuse (17.7%), hepatocellular carcinoma (17.5%) or liver transplant (5.7%); whereas survivors were more likely to be Asian (48.8%) (all, p<0.001). CHB patients died at an average age of 59.8 years, 14 years younger than the general US population and at higher rates for all causes (RR=1.854 [95% CI, 1.851 - 1.857]) and liver-related causes (RR=15.91 [95% CI, 15.81 - 16.01]). Only 19% of CHB decedents and 40% of those dying of liver disease had hepatitis B reported on their death certificates.
Conclusions:

Compared to the general population, CHB patients die at a younger age and at higher rates from all causes and liver-related causes. Death certificates underrepresent the true mortality from CHB.

PMID:
    30060032
DOI:
    10.1093/cid/ciy598

StephenW

Clin Infect Dis。 2018年7月28日doi：10.1093 / cid / ciy598。 [提前打印]
慢性乙型肝炎（CHB）感染患者的死亡率：慢性肝炎队列研究（CHeCS）。
Bixler D1，Zhong Y1，Ly KN1，Moorman AC1，Spradling PR1，Teshale EH1，Rupp L LB2，Gordon SC2，Boscarino JA3，Schmidt MA4，Daida YG5，Holmberg SD1; CHeCS调查员。
作者信息

1
    佐治亚州亚特兰大疾病控制和预防中心病毒性肝炎科。
2
    亨利福特健康系统，底特律密歇根州。
3
    盖辛格健康系统，宾夕法尼亚州丹维尔。
4
    Kaiser Permanente-Northwest，俄勒冈州波特兰市。
五
    Kaiser Permanente-Hawaii，檀香山。

抽象
背景：

根据死亡证明，美国每年约有1800人死于乙型肝炎（美国）;然而，这个数字可能低估了慢性乙型肝炎（CHB）的真实死亡率。
方法：

我们分析了2006年1月1日至2013年12月31日在慢性肝炎队列研究（CHeCS）中观察到的CHB患者的数据。我们比较了CHeCS CHB死者和美国死者的总死亡率和原因特异性死亡率以及平均死亡年龄。多个死因（MCOD）文件。
结果：

截至2014年12月31日，共有4389名CHB患者被平均随访5.38年; 492例（11％）CHB患者在平均随访3。00年后死亡。与幸存者相比，死者年龄较大，更可能是白人（40.6％），非洲裔美国人（27.1％）或男性（74.2％），更可能患有肝硬化（59.8％），糖尿病（27.2％），酒精滥用（17.7％），肝细胞癌（17.5％）或肝移植（5.7％）;幸存者更可能是亚洲人（48.8％）（全部，p <0.001）。 CHB患者平均年龄59.8岁，比美国普通人群年轻14岁，所有原因发生率较高（RR = 1.854 [95％CI，1.851-1.857]）和肝脏相关原因（RR = 15.91 [ 95％CI，15.81 - 16.01]）。只有19％的CHB死亡者和40％死于肝病的人在他们的死亡证明中报告了乙型肝炎。
结论：

与一般人群相比，CHB患者在所有原因和肝脏相关原因中死亡的年龄较小且死亡率较高。死亡证明不足以代表CHB的真正死亡率。

结论：
    30060032
DOI：
    10.1093 / CID / ciy598