In a population-based analysis of chronic liver disease mortality in the US, the decline in hepatitis C virus (HCV)-related mortality coincided with the introduction of direct-acting antiviral (DAA) therapies, while the mortality from alcoholic liver disease (ALD) and nonalcoholic fatty liver disease (NAFLD) increased during the same period. Researchers collected data from the US Census and National Center for Health Statistics mortality record, identifying individuals with HCV infection, ALD, NAFLD, or hepatitis B virus (HBV) infection. The trends in age-standardized mortality of chronic liver diseases among adults aged ≥20 years in the US was examined, from 2007 through 2016. They found:

• Age-standardized HCV-related mortality increased from 7.17 per 100,000 persons in 2007 to 8.14 per 100,000 persons in 2013, followed by a marked decrease in the time period at which patients began receiving treatment with DAAs.
• The annual percentage change (APC) in HCV mortality increased 2.0% per year from 2007 through 2014 but decreased 6.4% per year from 2014 through 2016.
• In contrast, age-standardized mortality increased for ALD and NAFLD.
• HBV-related mortality decreased steadily from 2007 through 2016.
• Minorities in the US have disproportionately higher chronic liver disease-related mortality.