The team pinpointed a total of seven distinct causes of death: primary liver cancer, other liver disease, external causes such as accidents, homicide, and suicide, non-liver cancers, diseases of the circulatory system, and “other” causes. Of the 78 deaths, 18 were due to drug-related causes while nine were caused by primary liver cancer. In younger patients (those under 50), more than half of the deaths were due to drug-related issues, while older patients (those over 50) were more likely to die from liver cancer. Interestingly, the Centers for Disease Control (CDC) report
that men die from liver cancer at more than twice the rate of women and that as of 2013, cases of liver cancer and related deaths are on the rise.
Although the researchers emphasized that several factors were missing from the study that would provide a complete picture of the issue, they said that they were able to conclude that “health risk behaviors emerged [in the study] as the major modifiable risk factor for mortality in the [SVR] population.” The group recommended a multidisciplinary approach to hepatitis C treatment that not only offers medical treatment, but also addresses lifestyle risk factors. “The SVR time-point may be a particularly opportune moment to assess what other services and support the patient may be in need of,” they said, adding that the high incidence of liver-cancer-related deaths indicates that regular screenings for liver cancer could also improve mortality rates.
“It will be important to repeat this analysis five years hence,” they said, noting that new trends in treatment regimens that include “intensive coaching from clinicians and nursing staff” could positively affect patients’ resolve to make healthier lifestyle decisions after achieving SVR. They added that hepatitis C tends to disproportionately affect populations of lower socioeconomic status, a state that is also associated with higher mortality rates. A spokesperson for the Centers for Disease Control (CDC) agreed with the team’s conclusions about using SVR as a point at which to identify and modify risky behaviors, noting, “Once cured, it is still important for patients to protect themselves against any activity that puts them at risk of being re-infected.” Such activities, such as intravenous drug use, were pinpointed by the research team as leading to a large number of “excess” deaths in the cured population.
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