Unlabelled: In resource-rich countries, chronic hepatitis C (CHC) infection is associated with a sizeable excess mortality risk. The extent to which this is due to (1) the biological sequelae of CHC infection versus (2) a high concomitant burden of health risk behaviors (HRBs) is unclear. We used data from the 1999-2010 U.S. National Health and Nutritional Examination Surveys (NHANES), which include detailed information on HRBs and CHC infection status. We calculated the prevalence of the five major HRBs-alcohol use; cigarette smoking, physical inactivity, unhealthy diet, and illicit drug use-according to CHC after adjusting for sociodemographic differences. Mortality status after survey interview was ascertained by linkage to the U.S. National Death Index. To assess the contribution of HRBs to the excess mortality risk, we determined the all-cause mortality rate ratio (MRR) for individuals with CHC relative to individuals without, and then calculated the attenuation in this MRR following adjustment for HRBs. This analysis included 27,468 adult participants of NHANES of which 363 tested positive for CHC. All HRBs were markedly more prevalent among individuals with CHC versus individuals without. CHC was associated with a 2.4-fold higher mortality rate after adjustment for sociodemographic factors (MRR, 2.36; 95% CI, 1.60-3.49). Subsequent adjustment for all five HRBs attenuated this ratio by 50.7% to MRR 1.67 (95% CI, 1.14-2.44). Higher levels of attenuation (69.1%) were observed among individuals aged 45-70 years, who form the target demographic for U.S. birth cohort screening.
Conclusion: At least half the excess mortality risk for individuals with CHC in the United States may be attributed to HRBs rather than CHC. The remedial response to hepatitis C must not neglect action on HRBs if it is to fully resolve the high mortality problem in this population. (Hepatology 2018;67:97-107).
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1002/hep.29419 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The 2024 European Society of Intensive Care Medicine clinical practice guideline provide clinicians with evidence-based recommendations on intravenous fluid in critically ill adults across a range of common conditions. These guidelines aim to improve the practices of fluid therapy by adopting a global perspective that considers both clinical efficacy and resource utilization in diverse healthcare settings. The guidelines address three key questions: (1) albumin versus crystalloids, (2) balanced crystalloids versus isotonic saline, and (3) small-volume hypertonic solutions versus isotonic crystalloids.
View Article and Find Full Text PDFShort- and Long-Term Outcomes of Patients Who Underwent the Arterial Switch Operation at Siriraj Hospital-Thailand's Largest National Tertiary Referral Center.
World J Pediatr Congenit Heart Surg
January 2025
Division of Cardiothoracic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Objective: The aim of this study was to assess the short- and long-term outcomes of patients who underwent the arterial switch operation (ASO) at Siriraj Hospital in Thailand, and to identify postoperative complications and factors that significantly affect patient survival.
Materials And Methods: We retrospectively studied all patients with dextro-transposition of the great arteries and anatomic variants who underwent the ASO from January 1995 to December 2020. Twenty-year overall survival and 15-year freedom from reoperation/reintervention were estimated using the Kaplan-Meier method.
Cause-Specific Mortality and Prognostic Impact of Comorbidity in Japanese Patients With Chronic Lymphocytic Leukemia.
Cancer Med
February 2025
Division of Hematology/Oncology, Department of Internal Medicine, Kameda Medical Center, Chiba, Japan.
Background: Due to its rarity, there are very limited data available on the cause of death (COD) and its association with comorbidities in Japanese chronic lymphocytic leukemia (CLL) patients.
Methods: To investigate the prevalence of comorbidities and their impact on cause-specific mortality, we retrospectively reviewed 121 Japanese patients with CLL.
Results: The median age was 69 years, with 47.
Prognostic signature based on mitochondria- and angiogenesis-related genes associated with immune microenvironment of multiple myeloma.
Hematology
December 2025
Department of Hematology, XuChang Central Hospital, XuChang, People's Republic of China.
Introduction: Mitochondria and angiogenesis play key roles in multiple myeloma (MM) development, but their interrelated genes affecting MM prognosis are under-studied.
Methods: We analyzed TCGA_MMRF and GSE4581 datasets to identify four genes - CCNB1, CDC25C, HSP90AA1, and PARP1 - that significantly correlate with MM prognosis, with high expression indicating poor outcomes.
Results: A prognostic signature based on these genes stratified patients into high- and low-risk groups, with the latter showing better survival.
Association of Hospital Consolidation with Cancer Outcomes.
Inquiry
January 2025
Wayne State University School of Medicine, Detroit, MI, USA.
Hospital mergers have increased significantly since 2010, driven by factors such as healthcare policy changes, reimbursement, economies of scale, and quality improvement goals. However, limited evidence exists about how these mergers affect the quality of care and cancer outcomes. We conducted a difference-in-differences analysis to assess the impact of hospital consolidation on cancer outcomes.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!