Prevalence and comorbidities of chronic hepatitis C: a nationwide population-based register study in Sweden

Abstract

Purpose: The aim of this study was to estimate the prevalence of physician-diagnosed and registered chronic hepatitis C (CHC), and to estimate the reported frequencies of Charlson comorbidities compared with matched comparators from the general population.

Materials and methods: Patients were identified according to ICD codes for CHC in the Swedish National Patient Register (1997–2013). Prevalence was estimated according to different patient identification algorithms and for different subgroups. Charlson comorbidities were ascertained from the same register and compared with age/sex/county of residence matched general population comparators.

Results: A total of 34,633 individuals with physician-diagnosed CHC were alive in Sweden in 2013 (mean age, 49 years; 64% men), corresponding to a physician-diagnosed prevalence of 0.36%. The prevalence varied by case definition (0.22%-0.36%). The estimate dropped to 0.14% for monitored CHC disease (defined as ≥1 CHC-related visit in 2013). Overall, 41.3% of the CHC patients had ≥1 physician-registered Charlson comorbidity; the most common was liver diseases (22.1%). Compared with matched comparators from the general population (n = 171,338), patients with CHC had more physician-diagnosed and registered diseases such as chronic pulmonary disease (10.2% vs. 4.0%), diabetes (10.6% vs. 5.5%) and liver-related cancer (1.3% vs. 0.2%; all p < .01). No information on behavioural factors, such as smoking, alcohol consumption or on-going illicit drug use, was available.

Conclusion: The physician-diagnosed prevalence of CHC was slightly lower than previously reported estimates, and varied by case definition. The additional comorbidities observed in the CHC group should be taken into consideration, as these comorbidities add to the disease burden.

Keywords:

• Comorbidities
• hepatitis C
• matched general population comparators
• prevalence
• Sweden

Ethical approval

Ethical approval for this study was granted by the Regional Ethics Committee, Karolinska Institutet, Stockholm, Sweden.

Disclosure statement

The design, study conduct and financial support for the study were provided by AbbVie. AbbVie participated in the study design, data analysis, interpretation of results, review and approval of the publication. The authors determined the final content. No payments were made to the authors for writing this publication.

S. Aleman has consultancies or has received speaker fees from AbbVie, BMS, Gilead, Janssen, Merck, Medivir, Roche, and Tillotts Pharma, and has received research support from Gilead. O. Weiland has consultancies with AbbVie, BMS, Gilead, Janssen, Medivir, Roche, and MSD/Merck, and has worked on speaker bureaus for AbbVie, BMS, Gilead, Janssen, Medivir, Roche, and MSD/Merck. A.-S. Duberg has consultancies with or has received speaker fees from AbbVie, BMS, Medivir, MSD, Gilead, Janssen, and Roche. M. Lagging has consultancies with AbbVie, BMS, Gilead, Medivir, and MSD/Merck, and has worked on speaker bureaus for AbbVie, BMS, Gilead, Medivir, and MSD/Merck. J. Waldenström reports no conflicts of interest. J. Söderholm, J. Kövamees and K. Büsch are employees of AbbVie AB and may hold stocks or stock options in AbbVie. K. Büsch is also a registered PhD student at Karolinska Institutet.