Trends in all cause and viral liver disease-related hospitalizations in people with hepatitis B or C: a population-based linkage study

HBV and HCV notifications were linked to their hospital (July 2000-June 2006), HIV and death records. Standardized hospitalization ratios (SHRs) were calculated using rates for the NSW population. Random effects Poisson regression was used to examine temporal trends.The SHR for all causes and non alcoholic liver disease was two-fold higher in the HCV cohort compared with the HBV cohort (SHRs 1.4 (95%CI: 1.4-1.4) v 0.6 (95%CI: 0.6-0.6) and 14.0 (95%CI: 12.7-15.4) v 5.4 (95%CI: 4.5-6.4), respectively), whilst the opposite was seen for primary liver cancer (SHRs 16.2 (95%CI: 13.8-19.1) v 29.1 (95%CI: 24.7-34.2)). HIV co-infection doubled the SHR except for primary liver cancer in the HCV/HIV cohort. In HBV and HCV mono-infected cohorts, all cause hospitalization rates declined and primary liver cancer rates increased, whilst rates for non alcoholic liver disease increased by 9% in the HCV cohort but decreased by 14% in the HBV cohort (P < 0.001).Hospital-related morbidity overall and for non alcoholic liver disease was considerably higher for HCV than HBV. Improved treatment of advanced HBV-related liver disease may explain why HBV liver-related morbidity declined. In contrast, HCV liver-related morbidity increased and improved treatments, especially for advanced liver disease, and higher levels of treatment uptake are required to reverse this trend.Chronic infection with hepatitis B virus (HBV) or hepatitis C virus (HCV) is associated with increased morbidity and mortality. Several data linkage studies have reported an excess burden of hepatocellular carcinoma (HCC) and mortality, particularly from advanced liver disease [1-5]. They also highlight an increased disease burden associated with HBV/HIV, HCV/HIV and HBV/HCV co-infection [2-4,6]. These population-based studies outline the relative incidence of cancer and mortality, but there are limited data comparing the impact of HBV and HCV infection on hospitalization rates. The one published study compared the average