Since the introduction of direct-acting antiviral (DAA) therapies in 2014, mortality from hepatitis C-related cirrhosis has declined by about 8.2% per year, according to an analysis of public health data.
“DAAs have revolutionized the management of HCV by making it a curable disease,” presenting author Ashraf Ullah, MD, an internal medicine resident at Guthrie Robert Packer Hospital, Pennsylvania, and colleagues wrote in an abstract presented during the annual meeting of the American Association for the Study of Liver Diseases. “Despite these breakthroughs, hepatitis C remains a significant public health burden in the United States, particularly among historically underserved populations. Understanding mortality trends over time can provide critical insight into the effectiveness of public health interventions and identify persistent health care disparities.”
The researchers analyzed U.S. mortality data from the CDC WONDER database, focusing on cirrhosis as the underlying cause of death and hepatitis C virus (HCV) as a contributing cause. They calculated age-adjusted mortality rates per 100,000 and used Joinpoint regression to identify trends, focusing on annual percentage changes (APCs) from 1999 to 2023.
From 1999 to 2024, HCV-related cirrhosis accounted for 175,712 deaths. Mortality rates rose from 2.9 in 1999 to 3.8 in 2013, but things changed after DAAs were introduced. Rates began to fall, dropping from 3.8 in 2014 to 2.3 in 2024, an 8.2% decrease each year. Men consistently had higher mortality rates than women. For men, rates increased by about 1.5% per year until 2014, then fell by 9% annually through 2021. For women, rates went up by 1.4% each year until 2013 and then declined by 8.8% annually from 2014 to 2019.
In other findings, mortality rates began to decline across all racial groups after 2013, with the steepest decline seen in non-Hispanic Black populations (APC: -11%). In 2022, non-Hispanic American Indian/Alaska Native populations had the highest mortality rate (5.1 per 100,000), followed by Hispanics (2.5 per 100,000), non-Hispanic Black (2.4 per 100,000), non-Hispanic White (1.7 per 100,000), and non-Hispanic Asian populations (0.8 per 100,000).
Mortality rates for HCV were highest among men, people aged 55–74, American Indian or Alaska Native individuals, those living in the Western U.S., and residents of medium to small metropolitan areas.
The researchers did not disclose any conflicts of interest.
Source: AASLD
