Death certificates and HCV underreporting


Subject: Death certificates. Yuck. But here goes anyway. According to two Grim-Reapernational (non-VA) studies, death comes calling more often in the guise of HCV than death certificates reflect. And the conclusions drawn from them must have those in government unnerved.

Link:  From the CDC: Mortality Among Persons in Care With Hepatitis C Virus Infection: The Chronic Hepatitis Cohort Study (CHeCS), 2006–2010: February 12, 2014

Researchers looked at health records from patients who had died of HCV from four US healthcare systems. Then they compared them with their death certificates.  Despite confirmed chronic HCV infection, only 19% of decedents had HCV infection listed on their death certificates.  For decedents who had a liver transplant before death, HCV was listed only listed on 29% of death certificates.

As there were 16,622 death certificates in the United States listing HCV as an underlying or contributing cause of death in 2010, we extrapolate that only one-fifth of persons with HCV who die are having HCV recorded on their death certificates. Thus, our analysis suggests that at least 80,000 persons with HCV may have actually died in 2010.

HCV-infected persons also died prematurely at around 59 years instead of 74 years in the general population.  The authors say that people are dying from HCV rather than just with HCV.

The second study wanted to determine the cause of death in NYC decedents infected with HCV.

LINK: NYC Deaths Among People With Hepatitis C in New York City, 2000–2011

They also found that New Yorkers died prematurely (median age 60). Now here comes a major understatement:  “The short interval between HCV report and death suggests a need for earlier testing and improved treatment.”

Cardiovascular disease seems to be a major “side effect” of HCV infection in NYC’s diverse population. “Decedents with HCV monoinfection died from cardiovascular causes (26.3%), followed by nonliver cancer (16.1%), hepatitis C (11.6%), liver cancer (8.7%), and drug-related causes” on their death records.

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“Causes of death by quartile of age at death for all decedents reported with hepatitis C virus (HCV) monoinfection, New York City, 2000–2011. Excludes “other” category and human immunodeficiency virus/AIDS; HCV-related includes liver cancer, cirrhosis, and HCV.” Clin Infect Dis. 2014 Apr 58(8) 1047-54, Figure 2

As a native New Yorker, I can affirm that city studyzazoufolk walk a lot and that’s great for healthy hearts.  Clearly the association between HCV and heart disease should be looked into further and death certificates need improvements.  The full-text articles referred to are free to read by clicking the underlined links above.

Civilians and veterans in the boomer cohort need some answers and closure about this epidemic, and please, don’t blame dancing to rock music at Woodstock with “flowers in our hair” or cannabis as causal because no one is buying that nonsense. 

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5 Responses to Death certificates and HCV underreporting

  1. Kiedove says:

    Hepper, you can’t remind us enough about this issue. Because my family needed me to be home, I had to give up my career and care for them. My hubby was the big earner, if he goes first, I will be low income. I know that Alison Hickey testified about some reforms that were needed to help survivors but just haven’t had the time to study the matter. Any information you gather and share will be most welcome.

    • hepper74 says:

      As we all know by now, or if there are newbies reading this, HCV is not entirely THE disease but rather what other diseases follow along with it. Diabetes has many insidious problems of its own and if not controlled can lead to death. Hypertension, aka high blood pressure, certainly can put you out in the pasture. Various and sundry types of cancer can and do occur. Relating all diseases back to HCV is not that difficult but it is surprising that more people refrain from connecting the two. In any event I implore you to get the correct cause of death on the certificate to protect those you leave behind and it also provides fodder for the VA to suck on when they try and deny your family the benefits that they deserve.

    • hepper74 says:

      Kiedove, you can file for and receive your husbands Social Security if he passes before you. I worked for over 23 years in construction and my wife will be claiming my benefits when I get outta here. My SSDI and VA comp will allow her to live comfortably albeit not lavishly. The only way that she gets the death benefit is if they link my death to one or all of the diseases which have taken up residence and therefore when they find a new illness I go online and search for any relevance to HCV. Sounds kind of morbid but I cannot see my family suffering due to incompetence over at the house of cards.

      • Kiedove says:

        I’ll get his SS, not sure if 100%, but VA his compensation will end unless, as you say, other related disease can be applied for. There’s a child’s picture book in our home library called, “Just Enough is Plenty.” It’s a modern folktale about the Hannukkah miracle and the setting is Poland before the Holocaust. I just love the title and message. For those who don’t seek to live a “big life,” it makes sense. I expect I’ll have “just enough” resources and that it will be “plenty” for my needs!

  2. hepper74 says:

    To all of you who use this blog please, please, please make sure that your loved ones know that you expect an autopsy to be performed. The reason behind this is that there are multiple ailments that come with having HCV and IF your hep-C is SC and you expire due to it then your living family members should have an easier time when filing for your benefits.

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