Posted on 07/19/2018 5:14:04 PM PDT by spintreebob
Objective To describe liver disease related mortality in the United States during 1999-2016 by age group, sex, race, cause of liver disease, and geographic region.
Based on Death certificate data from the Vital Statistics Cooperative, and population data from the US Census Bureau compiled by the Center for Disease Control and Prevention’s Wide-ranging Online Data for Epidemiologic Research (1999-2016).
From 1999 to 2016 in the US annual deaths from cirrhosis increased by 65%, to 34 174, while annual deaths from hepatocellular carcinoma doubled to 11,073. Annual increases in cirrhosis related mortality were most pronounced for Native Americans (4.0%, 2.2% to 5.7%). The age adjusted death rate due to hepatocellular carcinoma increased annually by 2.1% (1.9% to 2.3%); deaths due to cirrhosis began increasing in 2009 through 2016 by 3.4% (3.1% to 3.8%). During 2009-16 people aged 25-34 years experienced the highest average annual increase in cirrhosis related mortality (10.5%, 8.9% to 12.2%), driven entirely by alcohol related liver disease. During this period, mortality due to peritonitis and sepsis in the setting of cirrhosis increased substantially, with respective annual increases of 6.1% (3.9% to 8.2%) and 7.1% (6.1% to 8.4%). Many, concentrated in the south and west, observed disproportionate annual increases: Kentucky 6.8% (5.1% to 8.5%), New Mexico 6.0% (4.1% to 7.9%), Arkansas 5.7% (3.9% to 7.6%), Indiana 5.0% (3.8% to 6.1%), and Alabama 5.0% (3.2% to 6.8%). No state showed improvements in hepatocellular carcinoma related mortality, while Arizona (5.1%, 3.7% to 6.5%) and Kansas (4.3%, 2.8% to 5.8%) experienced the most severe annual increases.
Conclusions: Mortality due to cirrhosis has been increasing in the US since 2009. Driven by deaths due to alcoholic cirrhosis, people aged 25-34 have experienced the greatest relative increase in mortality. White Americans, Native Americans, and Hispanic Americans experienced the greatest increase in deaths from cirrhosis. Mortality due to cirrhosis is improving in Maryland but worst in Kentucky, New Mexico, and Arkansas. The rapid increase in death rates among young people due to alcohol highlight new challenges for optimal care of patients with preventable liver disease.
mmmm wonder what else was happening 2009-2016 while Native Americans and Blacks were increasingly going to alcohol and death?
Consider the cost to both private insurance and Medicaid .... to you ... and me.
Medicaid pays a small amount for pregnant moms, babies and kids. Medicaid pays a large amount for seniors and end-of-life causes.
Between 18 and 74, the #1 killer is lifestyle. The #1 cost to us is other people's lifestyle mistakes.
They were depressed over Obama as POTUS.
.
Don’t abuse booze or drugs and don’t contract hepatitis...particularly Hep C.
I'll drink to that!
dying is the leading cause of death
Alcoholic deaths are a terrible thing
Wow. That article was discouraging. After reading that, I need a drink.
I hope active alcoholics are miserable and die.
Bad hootch?
Doesn't matter whos in charge. The fault is on the person drinking. Kinda like blaming McDonald's for all the fatties around here. Sure, blame a President. No thanks.
Not that I would volunteer for it again, but why "particularly Hep C"?
It's curable.
I know.
I'm cured (80's tattoos). d:^)
It's my understanding that Hep C is often a strong factor in the development of cirrhosis and liver cancer.It's also my understanding that even with recent advances the jury is still out regarding claims of "cures".I'm somewhat familiar with this general subject because an ER nurse I once worked with developed both HIV and Hep C after experiencing a needle stick...something that's quite common in critical care medicine.
“Medicaid pays a large amount for seniors and end-of-life causes”
Are you talking about the indigent and spend-down cases where Medicaid is paying Medicare premiums? If not then to what situation are you referring?
What an evil comment. I think I’ll pray for your soul rather than get angry at you though. I have family members who have fought hard against this illness, but addiction is a hard thing to overcome. It’s also been shown to be highly influenced by genes, and people who have suffered a lot of abuse and depression are more likely to be alcoholics. But they get no sympathy from someone so hate-filled and indecent as you. The only deserve to suffer and die. Thanks for sharing your disgusting opinion with the world.
Walp, yer correct on that point m'FRiend.
I'm sure my other half, who is program manager at a large Infectious Disease clinic specializing in advanced liver disease, will be along directly.
There's a lot of d/misinformation out there on liver disease. d:^)
I am CopperTop's other half, a nurse for nearly 28 years, and program manager of an Advanced Liver Diseases clinic at a very large hospital. I feel pretty qualified to answer your comment.
You are partially correct that Hep C is a strong factor in the development of cirrhosis and liver cancer. But you left out an important word in your sentence, and that word is untreated. In fact, untreated Hep C is the biggest risk factor for liver cancer, and the leading cause of liver transplants in the U.S.....disclaimer being that Hep C is the leading cause of liver transplants because people who are actively drinking are ineligible for a transplant.
Your understanding of the jury being out on "cures" for hepatitis c is incorrect. I'm not sure when your ER nurse friend suffered the needlestick, but prior to late 2013, there were only marginal treatments for Hep C. If it was back then, it is absolutely true that the only available treatments were worse than the disease itself. Interferon is a difficult medicine to take for almost anyone.
In May of 2011, the FDA cleared 2 medications, Boceprevir and Telaprevir, for the treatment of Hepatitis C. They were the primitive beginnings of a totally new way to treat Hepatitis C, a class of meds called DAA's. DAA means "direct-acting antiviral." I say primitive because even since then, medical knowledge of Hep C has increased exponentially. There are actually 7 different types of Hep C (calleld genotypes), and these new meds were only effective against one or two at most. Additionally, only in the last 5-6 years did the understanding of the mechanisms of viral resistance in Hep C become clear, so some of these primitive meds were ineffective because people had resistance patterns in their virus, but no one knew it back then.
Currently, there are some 15 DAA's on the market, and most of the newest ones are effective against all types of Hepatitis C and most types of resistance all in one pill. Look up Zepatier, Epclusa, Vosevi and Mavyret as examples. You still see Harvoni commercials on TV, but in my industry, Harvoni is somewhat old news.....it is only effective against 2 types of Hep C.
Prices of hep C medications were out of control for a long time. What the fine folks at Gilead Sciences forget to mention in their TV ad is that the current non-government market price for Harvoni is $440 per pill. However, for facilities with contracts to purchase large amounts of the Hep C meds, competition as the newer meds have come along has driven prices way down. Unfortunately, in the private sector, prices for the newer meds have not come down much, and Harvoni is still the first option because the price has come down as better medications become available. When Harvoni first came out, it was $1100/pill.
More than 100,000 patients in the U.S. have been cured of Hepatitis C, which is defined by the CDC as the absence of Hepatitis C virus in their blood 3 months after they stop their Hep C meds. In 90% percent of these cured patients, they have follow-up viral loads every year, and over many years have remained free of virus. Having been involved with 7500+ Hep C patients over the last 5 years, I know of exactly 2 who "relapsed" and became Hep C positive after being cured. The reality is in both of these patients, it is a much greater likelihood that they did not relapse, but rather, have a new Hep C infection from another exposure (i.e., went back to sharing needles). My 7500+ are just a drop in the bucket of those who have been treated nationally, and my numbers are consistent with national percentages. Even after being cured, there is no immunity and no way to prevent re-infection. Take-away point is that if you use drugs, don't share your works or use anyone elses.
Alcoholic hepatitis is actually far more deadly than even untreated Hepatitis C. If they don't stop drinking, 30-40 percent of people with severe alcoholic hepatitis will die within 3 months. Even if they stop drinking, the likelihood of confounding medical factors is high: they have likely developed major kidney problems (read on hepato-renal syndrome) as well as being severely malnourished which leads to a host of other problems, too.
The earliest people who have been treated with DAA's, even the primitive ones, have remained Hep C free after 15 years or more. DAA's may have hit the public market in 2011, but they were in clinical trials for 7-10 years before that, and it is these people I refer to.
Sorry for the long dialogue, but I consider it a public health service to make sure accurate information is out there. Hep C IS curable, and is a bad dude to be sure. But alcohol is FAR, FAR worse.
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