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Excess mortality rate associated with hepatitis C virus infection: A community-based cohort study in rural Egypt

Abstract : Background & aims: >80% of people chronically infected with hepatitis C virus (HCV) live in resource-limited countries, yet the excess mortality associated with HCV infection in these settings is poorly documented. Methods: Individuals were recruited from three villages in rural Egypt in 1997-2003 and their vital status was determined in 2008-2009. Mortality rates across the cohorts were compared according to HCV status: chronic HCV infection (anti-HCV antibody positive and HCV RNA positive), cleared HCV infection (anti-HCV antibody positive and HCV RNA negative) and never infected (anti-HCV antibody negative). Data related to cause of death was collected from a death registry in one village. Results: Among 18,111 survey participants enrolled in 1997-2003, 9.1% had chronic HCV infection, 5.5% had cleared HCV infection, and 85.4% had never been infected. After a mean time to follow-up of 8.6years, vital status was obtained for 16,282 (89.9%) participants. When compared to those who had never been infected with HCV in the same age groups, mortality rate ratios (MRR) of males with chronic HCV infection aged <35, 35-44, and 45-54years were 2.35 (95% CI 1.00-5.49), 2.87 (1.46-5.63), and 2.22 (1.29-3.81), respectively. No difference in mortality rate was seen in older males or in females. The all-cause mortality rate attributable to chronic HCV infection was 5.7% (95% CI: 1.0-10.1%), while liver-related mortality was 45.5% (11.3-66.4%). Conclusions: Use of a highly potent new antiviral agent to treat all villagers with positive HCV RNA may reduce all-cause mortality rate by up to 5% and hepatic mortality by up to 40% in rural Egypt.
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https://hal-pasteur.archives-ouvertes.fr/pasteur-02875287
Contributor : Yusuke Shimakawa <>
Submitted on : Friday, June 19, 2020 - 3:37:26 PM
Last modification on : Friday, July 3, 2020 - 2:39:38 PM

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Aya Mostafa, Yusuke Shimakawa, Ahmed Medhat, Nabiel Mikhail, Cédric Chesnais, et al.. Excess mortality rate associated with hepatitis C virus infection: A community-based cohort study in rural Egypt. Journal of Hepatology, Elsevier, 2016, 64 (6), pp.1240-1246. ⟨10.1016/j.jhep.2016.02.033⟩. ⟨pasteur-02875287⟩

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