Mortality and cause of death in persons with chronic hepatitis B virus infection versus healthy persons from the general population in Denmark

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DOI

  • Signe Bollerup, University of Copenhagen
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  • Sofie Hallager, University of Copenhagen
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  • Frederik Engsig, University of Copenhagen
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  • Amanda Mocroft, National Center for Global Health and Medicine, Institute for Global Health Policy Research, Bureau of International Health Cooperation, Tokyo
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  • Henrik Krarup, Department of Molecular Diagnostics, Aalborg University, Aalborg, Department of Nephrology, Aalborg Hospital, Aarhus University Hospital, Moelleparkvej 4, 9000 Aalborg, Denmark ; Center for Cardiovascular Research, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark., Department of Medical Gastroenterology
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  • Lone G Madsen, Reviewer - Academic Assessments - Zealand University Hospital, Region Zealand
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  • Peter Thielsen, Herlev Hospital, Oncology, Herlev
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  • Ulla Balslev, Herlev Hospital, Oncology, Herlev
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  • Helene Mens, Department of Neurology Palmerston North Hospital Palmerston North New Zealand.
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  • Toke S Barfod, Reviewer - Academic Assessments - Zealand University Hospital, Region Zealand
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  • Mette R Clausen, University of Copenhagen
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  • Lise Hobolth, University of Copenhagen
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  • Alex L Laursen
  • Britta Tarp
  • Birgit T Roege, Department of Pediatrics, Kolding Hospital, Kolding, Denmark
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  • Jesper B Hansen, Department of Medical Gastroenterology, Department of Nephrology, Aalborg Hospital, Aarhus University Hospital, Moelleparkvej 4, 9000 Aalborg, Denmark ; Center for Cardiovascular Research, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark.
  • ,
  • Lone Mygind, Department of Nephrology, Aalborg Hospital, Aarhus University Hospital, Moelleparkvej 4, 9000 Aalborg, Denmark ; Center for Cardiovascular Research, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark.
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  • Peer B Christensen, HCA Hospital for Children, University of Southern Denmark, Odense University Hospital, Odense, Denmark.
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  • Jan Gerstoft, University of Copenhagen
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  • Nina Weis, University of Copenhagen

The study aimed to determine adjusted all-cause mortality and cause of death in persons with chronic hepatitis B virus (HBV) infection compared with age- and sex-matched persons from the general population. We used nationwide registers to identify persons aged ≥18 years with chronic HBV infection in 2002-2017 in Denmark and included 10 age- and sex-matched controls for each. Follow-up was from 6 months after diagnosis until death, emigration, or 31 December 2017. Mortality rate ratios (MRRs) adjusted for age, sex, employment, origin and comorbidity were calculated using Poisson regression. Unadjusted cause-specific mortality rate ratios with 95% confidence intervals were calculated assuming a Poisson distribution. A total of 6988 persons with chronic HBV infection and 69,847 controls were included. During a median follow-up of 7.7 years (range 0.0-15.5), 315 (5%) persons with-and 1525 (2%) without-chronic HBV infection died. The adjusted all-cause MRR was 1.5 (95% CI 1.2-2.0). Persons with chronic HBV infection had increased mortality due to liver disease including hepatocellular carcinoma (MRR 12.3 [8.6-17.7]), external causes (MRR 3.3 [2.5-4.7]), endocrine disease (MRR 3.2 [1.8-5.4]), genitourinary disease (MRR 3.2 [1.2-7.6]) and neoplasms (except hepatocellular carcinoma; MRR 1.6 [1.2-2.0]). In conclusion, this study showed an increased all-cause mortality in persons with chronic HBV infection in comparison with age- and sex-matched persons without chronic HBV infection which remained after adjustment for several confounding factors. Excess mortality was mainly associated with liver disease, but also external factors, endocrine disease, genitourinary disease and neoplasms (excluding hepatocellular carcinoma).

Original languageEnglish
JournalJournal of Viral Hepatitis
Volume29
Issue9
Pages (from-to)727-736
Number of pages10
ISSN1352-0504
DOIs
Publication statusPublished - Sep 2022

    Research areas

  • DANHEP, Scandinavia, general population, hepatitis B, nationwide

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