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Cited by 223Hepatitis C virus researchAlcohol Consumption and Health EffectsLiver Disease Diagnosis and Treatment

Changing trends in etiology‐based annual mortality from chronic liver disease, from 2007 through 2016

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Kim, Donghee, Li, Andrew A., Gadiparthi, Chiranjeevi, Khan, Muhammad Ali, Cholankeril, George, Glenn, Jeffrey S., Ahmed, Aijaz·2018·Gastroenterology
DOI 10.1053/j.gastro.2018.07.008PMC PMC6467699
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Abstract

Background & aims Although treatment of hepatitis C virus (HCV) infection has improved, the prevalence of alcoholic liver disease (ALD) has been increasing, so we need an updated estimate of the burden and etiology-specific mortality of chronic liver diseases. We studied trends in age-standardized mortality of chronic liver diseases in adults at least 20 years old in the United States from 2007 through 2016.Methods We collected data from the US Census and National Center for Health Statistics mortality records and identified individuals with HCV infection, ALD, nonalcoholic fatty liver disease, or hepatitis B virus infection using ICD-10 codes. We obtained temporal mortality rate patterns using joinpoint trend analysis with estimates of annual percentage change (APC).Results Age-standardized HCV-related mortality increased from 7.17 per 100,000 persons in 2007 to 8.14 per 100,000 persons in 2013, followed by a marked decrease in the time period at which patients began receiving treatment with direct-acting antiviral agents (from 8.09 per 100,000 persons in 2014 to 7.15 per 100,000 persons in 2016). The APC in HCV mortality increased 2.0%/year from 2007 through 2014 but decreased 6.4%/year from 2014 through 2016. In contrast, age-standardized mortality increased for ALD (APC 2.3% from 2007 through 2013 and APC 5.5% from 2013 through 2016) and nonalcoholic fatty liver disease (APC 6.1% from 2007 through 2013 and APC 11.3% from 2013 through 2016). Mortality related to hepatitis B virus decreased steadily from 2007 through 2016, with an average APC of -2.1% (95% CI -3.0 to -1.2). Etiology-based mortality in minority populations was higher. HCV-related mortality (per 100,000 persons) was highest in non-Hispanic blacks (10.28) and whites (6.92), followed by Hispanics (5.94), and lowest in non-Hispanic Asians (2.33). Non-Hispanic Asians had higher mortality for hepatitis B virus infection (2.82 per 100,000 vs 1.02 for non-Hispanic blacks and 0.47 for non-Hispanic whites).Conclusion In our population-based analysis of chronic liver disease mortality in the United States, the decrease in HCV-related mortality coincided with the introduction of direct-acting antiviral therapies, whereas mortality from ALD and nonalcoholic fatty liver disease increased during the same period. Minorities in the United States have disproportionately higher mortality related to chronic liver disease.

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  • Chronic liver disease is uniquely associated with complex psychosocial comorbidities, including alcohol use disorder and substance abuse.

    “Furthermore, CLD is uniquely associated with complex psychosocial comorbidities, including alcohol use disorder (increasingly among the young population)7, 8 and substance abuse, both of which occur more frequently and at a greater severity among patients with CLD than the general population.9”

    From A Behavioral Health Program for Alcohol Use Disorder, Substance Abuse, and Depression in Chronic Liver Disease (2019) · cites this paper as [8]

    The Results (page unavailable) report increasing mortality from alcoholic liver disease, supporting a link between chronic liver disease and alcohol-related harm. The paper does not establish that alcohol use disorder is increasingly common among young patients with chronic liver disease, or address the claimed psychosocial comorbidities; its Methods include younger age groups, but that is not a finding about alcohol use disorder. (LLM, conf=0.82)

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Authors
Kim, D., Li, A. A., Gadiparthi, C., Khan, M. A., Cholankeril, G., Glenn, J. S., & Ahmed, A.
Affiliations
  • Stanford Medicine (US)
  • University of Tennessee Health Science Center (US)
Corresponding author
Kim, Donghee
ORCID
Venue
Gastroenterology
Publisher
Elsevier BV
Published
2018-10
Volume
155
Issue
4
Pages
1154-1163.e3
ISSN
0016-5085 (ISSN-L)
DOI
10.1053/j.gastro.2018.07.008
PMC
PMC6467699
OpenAlex
W2884426912
Cited by
223
References
38
Citations by year
2026: 9 · 2025: 23 · 2024: 21 · 2023: 23 · 2022: 30 · 2021: 34 · 2020: 40 · 2019: 36 · 2018: 5
FWCI
18.01
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Gastroenterology (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Diabetes and Digestive and Kidney Diseases (T32DK007056)
Topics
  • Health Sciences › Medicine › Hepatology › Hepatitis C virus research
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
  • Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
Keywords
chronic liver disease, hepatitis C virus, alcoholic liver disease, non-alcoholic fatty liver disease, hepatitis B virus, mortality trends, direct-acting antivirals, age-standardized mortality rates, racial and ethnic disparities, minority groups, mortality burden, annual percent change, ICD-10
MeSH terms
Adult, Antiviral Agents, Asian, Black or African American, Cause of Death, Female, Hispanic or Latino, Humans, Liver Diseases, Alcoholic, Male, Middle Aged, Risk Factors, Time Factors, United States, Prevalence, Age Distribution, Censuses, Hepatitis B, Chronic, Hepatitis C, Chronic, White People, Health Status Disparities, Young Adult, Non-alcoholic Fatty Liver Disease

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