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

Autor: Filho HRM; Department of Infectious Diseases, University of São Paulo, School of Medicine, São Paulo, SP, Brazil.; Department of Health Sciences, Federal University of Jataí, Jataí, GO, Brazil., Bierrenbach ALS; Instituto de Ensino e Pesquisa, Hospital Sírio-Libanês, São Paulo, SP, Brazil., Capuani MLD; Department of Infectious Diseases, University of São Paulo, School of Medicine, São Paulo, SP, Brazil., Mendrone A Jr; Hemocentro de São Paulo, Fundação Pró-Sangue, São Paulo, SP, Brazil., Benzaken AS; Heitor Vieira Dourado, Tropical Medicine Foundation, Manaus, Amazon, Brazil., Machado SM; Department of Infectious Diseases, University of São Paulo, School of Medicine, São Paulo, SP, Brazil., Saivish MV; Department of Health Sciences, Federal University of Jataí, Jataí, GO, Brazil., Sabino EC; Department of Infectious Diseases, University of São Paulo, School of Medicine, São Paulo, SP, Brazil., Witkin SS; Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, New York, United States of America.; Institute of Tropical Medicine, University of São Paulo, São Paulo, SP, Brazil., Mendes-Corrêa MC; Department of Infectious Diseases, University of São Paulo, School of Medicine, São Paulo, SP, Brazil.; Institute of Tropical Medicine, University of São Paulo, São Paulo, SP, Brazil.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2019 Dec 19; Vol. 14 (12), pp. e0226566. Date of Electronic Publication: 2019 Dec 19 (Print Publication: 2019).
DOI: 10.1371/journal.pone.0226566
Abstrakt: 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.
Competing Interests: The authors have declared that no competing interests exist.
Databáze: MEDLINE
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