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

Gahrton, Caroline ; Håkansson, Anders LU ; Kåberg, Martin ; Jerkeman, Anna LU ; Häbel, Henrike ; Dalgard, Olav ; Duberg, Ann Sofi and Aleman, Soo (2021) In PLoS ONE 16(6 June).
Abstract

Aims 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. Methods 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). Results 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... (More)

Aims 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. Methods 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). Results 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. Conclusions 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.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
PLoS ONE
volume
16
issue
6 June
article number
e0253710
publisher
Public Library of Science (PLoS)
external identifiers
  • scopus:85108504481
  • pmid:34166475
ISSN
1932-6203
DOI
10.1371/journal.pone.0253710
language
English
LU publication?
yes
id
4918e15b-d612-4dee-853c-e15ae79a3286
date added to LUP
2021-08-23 08:45:31
date last changed
2024-06-15 14:56:19
@article{4918e15b-d612-4dee-853c-e15ae79a3286,
  abstract     = {{<p>Aims 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. Methods 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). Results 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. Conclusions 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.</p>}},
  author       = {{Gahrton, Caroline and Håkansson, Anders and Kåberg, Martin and Jerkeman, Anna and Häbel, Henrike and Dalgard, Olav and Duberg, Ann Sofi and Aleman, Soo}},
  issn         = {{1932-6203}},
  language     = {{eng}},
  number       = {{6 June}},
  publisher    = {{Public Library of Science (PLoS)}},
  series       = {{PLoS ONE}},
  title        = {{Mortality among amphetamine users with hepatitis C virus infection : A nationwide study}},
  url          = {{http://dx.doi.org/10.1371/journal.pone.0253710}},
  doi          = {{10.1371/journal.pone.0253710}},
  volume       = {{16}},
  year         = {{2021}},
}