Impact on mortality of being seropositive for hepatitis C virus antibodies among blood donors in Brazil: A twenty-year study


Autoři: Hélio Ranes de Menezes Filho aff001;  Ana Luiza de Souza Bierrenbach aff003;  Maria Ligia Damato Capuani aff001;  Alfredo Mendrone, Jr. aff004;  Adele Schwartz Benzaken aff005;  Soraia Mafra Machado aff001;  Marielena Vogel Saivish aff002;  Ester Cerdeira Sabino aff001;  Steven Sol Witkin aff006;  Maria Cássia Mendes-Corrêa aff001
Působiště autorů: Department of Infectious Diseases, University of São Paulo, School of Medicine, São Paulo, SP, Brazil aff001;  Department of Health Sciences, Federal University of Jataí, Jataí, GO, Brazil aff002;  Instituto de Ensino e Pesquisa, Hospital Sírio-Libanês, São Paulo, SP, Brazil aff003;  Hemocentro de São Paulo, Fundação Pró-Sangue, São Paulo, SP, Brazil aff004;  Heitor Vieira Dourado, Tropical Medicine Foundation, Manaus, Amazon, Brazil aff005;  Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, New York, United States of America aff006;  Institute of Tropical Medicine, University of São Paulo, São Paulo, SP, Brazil aff007
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: 10.1371/journal.pone.0226566

Souhrn

Introduction

Hepatitis C virus (HCV) infection is a major health problem associated with considerable risk of mortality in different regions of the world. The purpose of this study was to investigate the contribution of HCV infection on all-cause and liver-related mortality, in a large cohort of blood donors in Brazil.

Methods

This is a retrospective cohort study of blood donors from 1994 to 2013, at Fundação Pró-Sangue—Hemocentro de São Paulo (FPS). This cohort included 2,892 and 5,784 HCV antibody seropositive and seronegative donors, respectively. Records from the FPS database and the Mortality Information System (SIM: a national database in Brazil) were linked through a probabilistic record linkage (RL). Mortality outcomes were defined based on ICD-10 (10th International Statistical Classification of Diseases and Related Health Problems) codes listed as the cause of death on the death certificate. Hazard ratios (HRs) were estimated for outcomes using Cox multiple regression models.

Results

When all causes of death were considered, RL identified 209 deaths (7.2%) among seropositive blood donors and 190 (3.3%) among seronegative blood donors. Donors seropositive for HCV infection had a 2.5 times higher risk of death due to all causes (95% CI: 1.76–2.62; p<0.001). When only liver-related causes of death were considered, RL identified 73 deaths among seropositive blood donors and only 6 among seronegative blood donors. Donors seropositive for HCV infection had a 23.4 times higher risk of death due to liver related causes (95% CI: 10.2–53.9; p<0.001). Donors seropositive for HCV had a 29.5 (95%CI: 3.9–221.7), 2.8 (95% CI: 1.4–5.5) and a 1.9 (95% CI: 1.2–3.0) times higher risk of death due to hepatocellular carcinoma, infection or trauma, respectively, compared to seronegative donors.

Conclusions

All-cause and liver-related mortality rate was increased among blood donors seropositive for HCV compared with the mortality rate among seronegative blood donors. Our data confirms HCV as a relevant cause of death in Brazil and also suggest that interventions directed at following patients even after access to specific drug treatment are urgent and necessary.

Klíčová slova:

Blood donors – Brazil – Death rates – Hepatitis C – Hepatitis C virus – Liver diseases – Serology – Hepatitis


Zdroje

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