Mortality and causes of death among people who inject drugs living with chronic hepatitis C virus infection in Oslo, Norway.

Author: Charlotte Meinich Pihl, Kristian Malme , Kjersti Ulstein , Joakim Hauge , Olav Dalgard , Havard Midgard

Theme: Clinical Research Year: 2023

There is a paucity of data on mortality among people who inject drugs (PWID) and in particular those with recent drug use. This study aimed to assess all-cause mortality and liver-related mortality in a population of PWID living with chronic hepatitis C virus (HCV) infection.

A retrospective observational study that included consecutive individuals who sought HCV
treatment in the period 2013 and 2020. Data were linked to the Norwegian cause of Death Registry at the end of the study period.

Of the 506 individuals included (27.8% female, median age 49.1 years, 71.6% OAT, 77.0% recent injecting drug use), 39 participants were deceased by 31.12.2020. All-cause mortality rate in the cohort was 2.11 pr 100 PY (95% CI 1.50-2.88), with liver related mortality at 0.16 (95% CI 0.03-0.47) pr. 100 PY and 1.01 (95% CI 0.21-2.96) pr. 100 PY among those with liver cirrhosis. All-cause mortality was significantly lower among those who had received HCV treatment (1.37 pr 100 PY (95% CI 0.83-2.10) compared to untreated individuals 4.2 pr 100 PY (95% CI 2.58-6.54). All-cause mortality was highest among those aged 50-59 years 2.6 pr. 100 PY (95% CI 1.57-4.0), and the primary cause of death was drug related (28%).

This study revealed a high all-cause mortality among PWID with chronic HCV infection. New strategies aimed at reducing mortality in this vulnerable population are essential.

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