Mortality among amphetamine users with hepatitis C virus infection: A nationwide study.

<h4>Aims</h4>To investigate liver-related and all-cause mortality among amphetamine users with hepatitis C virus (HCV) infection and compare this with opioid users with HCV infection and the uninfected general population.<h4>Methods</h4>In this national register study of mort...

Full description

Bibliographic Details
Main Authors: Caroline Gahrton, Anders Håkansson, Martin Kåberg, Anna Jerkeman, Henrike Häbel, Olav Dalgard, Ann-Sofi Duberg, Soo Aleman
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2021-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0253710
_version_ 1818720873968828416
author Caroline Gahrton
Anders Håkansson
Martin Kåberg
Anna Jerkeman
Henrike Häbel
Olav Dalgard
Ann-Sofi Duberg
Soo Aleman
author_facet Caroline Gahrton
Anders Håkansson
Martin Kåberg
Anna Jerkeman
Henrike Häbel
Olav Dalgard
Ann-Sofi Duberg
Soo Aleman
author_sort Caroline Gahrton
collection DOAJ
description <h4>Aims</h4>To investigate liver-related and all-cause mortality among amphetamine users with hepatitis C virus (HCV) infection and compare this with opioid users with HCV infection and the uninfected general population.<h4>Methods</h4>In this national register study of mortality in persons notified with HCV infection 1990-2015 and a substance-related diagnosis in Sweden, amphetamine users (n = 6,509) were compared with opioid users (n = 5,739) and a matched comparison group without HCV infection/substance use (n = 152,086).<h4>Results</h4>Amphetamine users were observed for 91,000 years and 30.1% deceased. Crude liver-related mortality was 1.8 times higher in amphetamine users than opioid users (crude mortality rate ratio 1.78, 95% CI 1.45-2.19), but there was no significant difference when adjusting for age and other defined risk factors. An alcohol-related diagnosis was associated with liver-related death and was more common among amphetamine users. Crude and adjusted liver-related mortality was 39.4 and 5.8 times higher, respectively, compared with the uninfected group. All-cause mortality was lower than in opioid users (adjusted mortality rate ratio 0.78, 95% CI 0.73-0.84), but high compared with the uninfected group. External causes of death dominated in younger ages whereas liver-related death was more common among older individuals.<h4>Conclusions</h4>This national register study presents a higher crude risk of liver-related death among HCV-infected amphetamine users compared with opioid users or the uninfected general population. The higher risk of liver-related death compared with opioid users may be explained by lower competing death risk and higher alcohol consumption. Treatment of HCV infection and alcohol use disorders are needed to reduce the high liver-related mortality.
first_indexed 2024-12-17T20:29:46Z
format Article
id doaj.art-5a91c51137f1448085f0c791ea1ccc69
institution Directory Open Access Journal
issn 1932-6203
language English
last_indexed 2024-12-17T20:29:46Z
publishDate 2021-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS ONE
spelling doaj.art-5a91c51137f1448085f0c791ea1ccc692022-12-21T21:33:38ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-01166e025371010.1371/journal.pone.0253710Mortality among amphetamine users with hepatitis C virus infection: A nationwide study.Caroline GahrtonAnders HåkanssonMartin KåbergAnna JerkemanHenrike HäbelOlav DalgardAnn-Sofi DubergSoo Aleman<h4>Aims</h4>To investigate liver-related and all-cause mortality among amphetamine users with hepatitis C virus (HCV) infection and compare this with opioid users with HCV infection and the uninfected general population.<h4>Methods</h4>In this national register study of mortality in persons notified with HCV infection 1990-2015 and a substance-related diagnosis in Sweden, amphetamine users (n = 6,509) were compared with opioid users (n = 5,739) and a matched comparison group without HCV infection/substance use (n = 152,086).<h4>Results</h4>Amphetamine users were observed for 91,000 years and 30.1% deceased. Crude liver-related mortality was 1.8 times higher in amphetamine users than opioid users (crude mortality rate ratio 1.78, 95% CI 1.45-2.19), but there was no significant difference when adjusting for age and other defined risk factors. An alcohol-related diagnosis was associated with liver-related death and was more common among amphetamine users. Crude and adjusted liver-related mortality was 39.4 and 5.8 times higher, respectively, compared with the uninfected group. All-cause mortality was lower than in opioid users (adjusted mortality rate ratio 0.78, 95% CI 0.73-0.84), but high compared with the uninfected group. External causes of death dominated in younger ages whereas liver-related death was more common among older individuals.<h4>Conclusions</h4>This national register study presents a higher crude risk of liver-related death among HCV-infected amphetamine users compared with opioid users or the uninfected general population. The higher risk of liver-related death compared with opioid users may be explained by lower competing death risk and higher alcohol consumption. Treatment of HCV infection and alcohol use disorders are needed to reduce the high liver-related mortality.https://doi.org/10.1371/journal.pone.0253710
spellingShingle Caroline Gahrton
Anders Håkansson
Martin Kåberg
Anna Jerkeman
Henrike Häbel
Olav Dalgard
Ann-Sofi Duberg
Soo Aleman
Mortality among amphetamine users with hepatitis C virus infection: A nationwide study.
PLoS ONE
title Mortality among amphetamine users with hepatitis C virus infection: A nationwide study.
title_full Mortality among amphetamine users with hepatitis C virus infection: A nationwide study.
title_fullStr Mortality among amphetamine users with hepatitis C virus infection: A nationwide study.
title_full_unstemmed Mortality among amphetamine users with hepatitis C virus infection: A nationwide study.
title_short Mortality among amphetamine users with hepatitis C virus infection: A nationwide study.
title_sort mortality among amphetamine users with hepatitis c virus infection a nationwide study
url https://doi.org/10.1371/journal.pone.0253710
work_keys_str_mv AT carolinegahrton mortalityamongamphetamineuserswithhepatitiscvirusinfectionanationwidestudy
AT andershakansson mortalityamongamphetamineuserswithhepatitiscvirusinfectionanationwidestudy
AT martinkaberg mortalityamongamphetamineuserswithhepatitiscvirusinfectionanationwidestudy
AT annajerkeman mortalityamongamphetamineuserswithhepatitiscvirusinfectionanationwidestudy
AT henrikehabel mortalityamongamphetamineuserswithhepatitiscvirusinfectionanationwidestudy
AT olavdalgard mortalityamongamphetamineuserswithhepatitiscvirusinfectionanationwidestudy
AT annsofiduberg mortalityamongamphetamineuserswithhepatitiscvirusinfectionanationwidestudy
AT sooaleman mortalityamongamphetamineuserswithhepatitiscvirusinfectionanationwidestudy