High Mortality Rates Among Socially Disadvantaged HCV Patients

Psychosis and hepatic fibrosis associated with earlier mortality.

A recent Canadian study verified for researchers that hepatitis C virus (HCV) infection is a clear indicator of hepatic fibrosis when adjusting for alcohol dependence and age. Moreover, the study found that for socially disadvantaged people, the risk for illness and death is greater due to their socioeconomic status.

The study was based in a socially disadvantaged neighborhood in Vancouver, Canada where 371 participants were observed. In order for the participants to be a part of the study, they must have been living in single room occupancy hotels or recruited from the Downtown Community Court.

The participants were followed for a median 3.8 years and observed for 1269 person-years. They were assessed for physical and mental illnesses for which treatment is currently available. Patients’ health status were assessed using past medical records of their health-related hospitalizations, which were collected and analyzed by a team of psychiatrists.

Additionally, standardized interviews were conducted to establish a baseline of wellness for each individual involved in the study. During the study, 31 of the 371 participants died.

A Coroner report was collected and analyzed by the team of researchers for each individual who died during the study. Among participants aged 55 years and younger, psychosis and hepatic fibrosis were associated with earlier mortality.

Additionally, the study found that treatment rates for these conditions were low, with 32% of participants being treated for psychosis and 0% being treated for HCV. Comparatively, other common disorders found within this group, such as HIV and opioid dependence, were treated more frequently than HCV and psychosis.

“Adults living in marginalized conditions have significantly greater all-cause mortality rates than other Canadians,” the researchers wrote. “We found a greater than eightfold increase in mortality rate.”

The study concludes that hepatic fibrosis and psychosis are associated with increased mortality in people living in marginal conditions. Due to their mental states and socioeconomic status, patients are less likely to seek treatment for their treatable conditions despite the fact that Canada offers free health care to its inhabitants.

The study states that timely diagnosis and intervention could reduce the high mortality in marginalized inner city populations.