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Hepatitis C Under-Documented on Death Certificates

February 28, 2014

This article was reported by Healio.

Healio reported on a study of mortality among individuals with hepatitis C virus (HCV) infection, in which medical staff listed HCV as the cause of death for only 19 percent of those who died from the disease.

The researchers compared mortality data from patients in the Chronic Hepatitis Cohort Study (CHeCS) with that from 12 million death certificates in the Multiple Cause of Death (MCOD) database. From 2006 to 2010 11,703 individuals received diagnoses of HCV infection at CHeCS sites, and 1,590 (14 percent) of them died. The majority of the individuals in the CHeCS study were born between 1945 and 1965 and the mean age of death was 59 years, which was 15 years younger than that of individuals in the MCOD data.

Although patients with HCV had a confirmed diagnosis and approximately half of the deaths were liver-related, medical staff listed HCV on only 19 percent of the death certificates. The researchers reviewed the ICD-9-CM codes prior to the death of participants in the CHeCS cohort, revealing that 63 percent of them had chronic liver disease,76 percent had moderate fibrosis, and 60 percent had cirrhosis.

The researchers noted that the results indicate the huge underestimation of deaths among people with HCV infection and how this obscures the real medical and public health impact of the disease.

The full report, "Mortality among Persons in Care with Hepatitis C Virus Infection -- The Chronic Hepatitis Cohort Study (CHeCS), 2006-2010," was published online in the journal Clinical Infectious Diseases (2014; doi: 10.1093/cid/ciu077).

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