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The contributions of viral hepatitis and alcohol to liver-related deaths in opioid-dependent people.

Abstract：

BACKGROUND:Mortality rates are elevated among heroin-dependent populations compared to the general population. Liver disease is emerging as an important contributor to mortality as the heroin-dependent population ages. Two major risk factors for liver disease are hepatitis C virus infection and chronic heavy alcohol use. Both of these are highly prevalent among heroin dependent people, but their relative contribution to liver-related mortality is poorly understood. METHODS:Data recording all prescriptions of opioid substitution treatment in New South Wales, Australia, 1997-2005, were linked to the National Death Index. Crude and standardised mortality rates and standardised mortality ratios were calculated for liver-related and other major causes of death. Frequency counts were obtained for viral hepatitis and alcohol mentions in underlying liver deaths. RESULTS:There were 208 underlying liver deaths for a CMR of 72.4 per 100,000 py (95% CI 62.9, 82.9), and liver deaths occurred at 9.8 times the general population rate (95% CI 8.5, 11.2). There were increases in liver-related mortality over time. Viral hepatitis was mentioned in three-quarters (n=156, 76%), and alcohol in 43% (n=90) of underlying liver deaths. CONCLUSIONS:Liver-related deaths were shown to be increasing in this heroin-dependent population, and the majority of these deaths involved chronic viral hepatitis infection. Increased uptake of treatment for hepatitis C virus infection is crucial to reducing the burden of liver-related mortality in this population. Hepatitis B vaccination, and screening of OST patients for alcohol use disorders and delivery of brief interventions as clinically indicated may also be of benefit.

journal_name

Drug Alcohol Depend

journal_title

Drug and alcohol dependence

authors

Larney S,Randall D,Gibson A,Degenhardt L

doi

10.1016/j.drugalcdep.2012.11.012

subject

Has Abstract

pub_date

2013-08-01 00:00:00

pages

252-7

issue

3

eissn

0376-8716

issn

1879-0046

pii

S0376-8716(12)00453-X

journal_volume

131

pub_type

杂志文章

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