(1) Background: Accurate statistics on the causes of death in patients with chronic hepatitis B (CHB) are lacking. We investigated mortality rates and causes of death over time. (2) Methods: Data on patients newly diagnosed with CHB from 2007 to 2010 (cohort 1,n= 223,424) and 2012 to 2015 (cohort 2,n= 177,966) were retrieved from the Korean National Health Insurance Service. Mortality data were obtained from Statistics Korea. The causes of death were classified as liver-related (hepatic decompensation or hepatocellular carcinoma [HCC]) or extrahepatic (cardiovascular-related, cerebrovascular-related, or extrahepatic malignancy-related). (3) Results: Over a 10-year follow-up period of 223,424 patients (cohort 1) with CHB, the overall mortality was 1.54 per 100 person-years. The mortality associated with HCC was the highest (0.65 per 100 person-years), followed by mortality related to extrahepatic malignancies (0.26 per 100 person-years), and cardio/cerebrovascular diseases (0.18 per 100 person-years). In the non-cirrhotic CHB (87.4%), 70% (11,198/15,996) of patients died due to non-liver-related causes over ten years. The 10-year overall mortality was 0.86 per 100 person-years. Among these, mortality due to extrahepatic malignancies had the highest rate (0.23 per 100 person-years), followed by mortality related to HCC (0.20 per 100 person-years), and cardio/cerebrovascular diseases (0.16 per 100 person-years). The 5-year mortality associated with extrahepatic malignancies increased from 0.36 per 100 person-years (cohort 1) to 0.40 per 100 person-years (cohort 2). (4) Conclusions: Mortality related to HCC decreased, whereas mortality related to extrahepatic malignancies increased in the antiviral era. Extrahepatic malignancies were the leading cause of death among patients with CHB without cirrhosis.
(1) 背景：目前缺乏关于慢性乙型肝炎（CHB）患者死亡原因的准确统计数据。本研究旨在探讨不同时期CHB患者的死亡率及死因变化趋势。(2) 方法：从韩国国民健康保险公团数据库中提取2007-2010年（队列1，n=223,424）和2012-2015年（队列2，n=177,966）新诊断为CHB的患者数据。死亡率数据来源于韩国统计厅。死亡原因分为肝脏相关（肝失代偿或肝细胞癌[HCC]）和肝外原因（心血管相关、脑血管相关或肝外恶性肿瘤相关）。(3) 结果：在对223,424例CHB患者（队列1）进行的10年随访期间，总死亡率为每100人年1.54例。其中HCC相关死亡率最高（每100人年0.65例），其次是肝外恶性肿瘤相关死亡率（每100人年0.26例）和心脑血管疾病相关死亡率（每100人年0.18例）。在非肝硬化CHB患者（87.4%）中，十年间70%（11,198/15,996）的患者死于非肝脏相关原因，10年总死亡率为每100人年0.86例。其中肝外恶性肿瘤相关死亡率最高（每100人年0.23例），其次是HCC相关死亡率（每100人年0.20例）和心脑血管疾病相关死亡率（每100人年0.16例）。肝外恶性肿瘤相关5年死亡率从队列1的每100人年0.36例上升至队列2的每100人年0.40例。(4) 结论：在抗病毒治疗时代，CHB患者的HCC相关死亡率下降，而肝外恶性肿瘤相关死亡率上升。对于非肝硬化CHB患者，肝外恶性肿瘤已成为首要死亡原因。
肿瘤(癌症)患者之家