Chiung M. Chen, MA, Hsiao-ye Yi, PhD, and Young-Hee Yoon, PhD. Alcohol Epidemiologic Data System, NIH/NIAAA, CSR, Incorporated, 2107 Wilson Boulevard, Suite 1000, Arlington, VA 22201, 703-312-5220, hyi@csrincorporated.com

Research has found that the average age at death is younger for decedents with co-occurring liver cirrhosis and Hepatitis C virus (HCV) infection than for decedents with liver cirrhosis alone. Clinical evidence also indicates that alcohol drinking exacerbates HCV’s progression toward fatal liver cirrhosis. This study examines the age patterns of mortality due to co-occurring HCV and liver cirrhosis, especially alcohol-related liver cirrhosis, in the U.S. population. Using the 2000 Multiple Cause of Death data and the postcensal population data, multiple-cause life tables were constructed for 15 categories of causes of death based on ICD-10 codes, including cirrhosis (alcohol-related, specified without mention of alcohol, and unspecified without mention of alcohol) as underlying cause with and without HCV as a contributing cause; HCV as underlying cause with and without cirrhosis as a contributing cause; and all other conditions as underlying cause with either cirrhosis or HCV or neither as a contributing cause. For these cause categories, conditional survival curves were presented in graphs and lifetime probabilities of death and years of life lost were calculated for the total population and for sex and racial subgroups. Of the 2,403,351 deaths in 2000, 46,906 involved cirrhosis or HCV or both. Life table survival curves showed little difference in mortality risks among the competing cause categories involving cirrhosis/HCV before age 40. After age 40, the conditional survival probabilities of HCV were generally lower than those of cirrhosis without HCV, and alcohol-related cirrhosis with co-occurring HCV had the lowest survival probabilities among the 15 categories.

Learning Objectives:

• Analyze multiple cause of death data.
• Construct multiple-cause life tables.
• Describe the concept of lifetime probabilities of death and period expected years of life lost.
• Evaluate survival probabilities conditional on deaths due to cirrhosis and HCV.

Keywords: Alcohol, Mortality

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.