AIMS:Acute kidney injury (AKI) may increase the risk of hypoglycaemia in patients with diabetes due to reduced insulin clearance and altered glucose metabolism. However, the impact of AKI on glycaemic status in non-critically ill hospitalised patients with diabetes is not well understood. METHODS:We included 166 hospitalised patients with type 2 diabetes on basal-bolus insulin monitored by continuous glucose monitoring (CGM). Kidney function was measured daily via plasma creatinine levels, and AKI was staged per Kidney Disease Improving Global Outcomes (KDIGO) guidelines. Multivariate models assessed associations between kidney function and CGM-based glycaemic outcomes. RESULTS:AKI correlated with a 7.3%-point (95% CI 0.3-14.2) reduction in time in range (TIR, 3.9-10.0 mmol/L), driven by increased time above range (TAR, >10.0 mmol/L), with no significant change in time below range (TBR, <3.9 mmol/L). AKI was also associated with approximately a tenfold increase in the risk of in-hospital mortality and intensive care unit (ICU) admission, and the risk of being readmitted within 30 days was twice as high. TIR decreased by 7.6%-point (95% CI 2.6-12.5) for each 100 μmol/L increase in plasma creatinine levels. CONCLUSION:AKI and high plasma creatinine are associated with hyperglycemia, in-hospital mortality, referral to ICU, and 30-day unscheduled readmissions in hospitalised patients with type 2 diabetes. These findings challenge the prevailing focus on hypoglycemia prevention during AKI, emphasising the importance of addressing hyperglycemia as well.

Background: No widely adopted continuous glucose monitoring (CGM)-based insulin titration protocol exists, which may limit the effects of inpatient CGM on glycemic and clinical outcomes. We evaluate the acceptability and operability of the protocol proposed by Olsen et al for inpatients with type 2 diabetes in non-intensive care unit (non-ICU) settings.Method: 7 inpatient diabetes team members, responsible for daily insulin titration, decided on insulin adjustments for 353 days. The members had the option to follow the CGM-based insulin protocol or override it for basal, prandial, and correctional insulin, separately, in 84 inpatients monitored by CGM. Questionnaires were used to evaluate the protocol's operability by the teams.Results: Of 456 basal insulin titration decisions, 439 (96.3%) adhered to the protocol. For prandial insulin, adherence rates were 83.9% (125/149) for breakfast, 87.2% (130/149) for lunch, and 92.6% (138/149) for dinner (p=0.163). All correctional insulin titrations adhered to the protocol. All team members expressed a preference for having a protocol for CGM-based insulin titration and rated the protocol's usability on a 1 to 10 scale, with mean scores (SD) of 8.7 (0.9) for basal insulin, 8.3 (1.4) for prandial insulin, and 7.4 (1.9) for correctional insulin.Conclusions: The CGM-based insulin titration protocol by Olsen et al has been successfully implemented for titrating basal, prandial, and correctional insulin in inpatients with type 2 diabetes in non-ICU settings. It was highly accepted by inpatient diabetes teams and provides a framework for effective CGM implementation in these settings.

Objective:To characterize glucose levels and insulin use daily and during hospital shifts throughout hospitalization, which might inform treatment planning and improve outcomes. Methods:This is a post hoc analysis from a 2-center randomized trial with 166 nonintensive care unit hospitalized patients with type 2 diabetes. Diabetes management was performed by regular staff, guided by diabetes teams using insulin titration algorithms based on either point-of-care glucose testing (POC arm) or continuous glucose monitoring (CGM arm). POC-arm participants wore blinded continuous glucose monitors. The primary outcome was the development in time in range (TIR) (3.9-10.0 mmol/L) between arms during hospitalization. Results:TIR improved progressively to nearly 90% in the CGM arm by discharge, compared to 60% in the POC arm, which plateaued after day 5 (P < .001). Both arms showed the lowest TIR and highest insulin use during the day shift (07:00-15:00 hours). Correctional insulin doses were lower in the CGM arm compared to the POC arm across all shifts: 0.7 IU (±0.3) lower during day shifts (07:00-15:00 hours, P = .016), 1.2 IU (±0.4) lower during evening shifts (15:01-23:00 hours, P = .005), and 0.3 IU (±0.1) lower during night shifts (23:01-06:59 hours, P = .038). Prandial insulin doses were 1.1 IU (±0.5) lower during evening shifts in the CGM arm (P = .021). Conclusion:TIR improved continuously to nearly 90% in the CGM arm by discharge, compared to 60% in the POC arm, which plateaued after day 5, despite lower daily insulin doses in the CGM arm. These findings underscore the sustained effectiveness of CGM in enhancing glycemic levels throughout the entire duration of hospitalization.

AIMS:Continuous glucose monitoring (CGM) is increasingly recognised as a valuable tool in the hospital setting, with evidence supporting its accuracy and potential for improving glycaemic and clinical outcomes. However, patient perspectives on the use of CGM in the hospital setting remain underexplored. This study investigates patient satisfaction with CGM during hospitalisation. METHODS:This analysis included 166 hospitalised non-intensive care unit (non-ICU) patients with type 2 diabetes from the DIAbetes TEam and Cgm (DIATEC) trial. Participants were randomised to either point-of-care (POC) glucose testing (n = 82) or CGM (n = 84) for glucose monitoring during their hospital stay and were managed by inpatient diabetes teams. At discharge, patients completed a survey developed for this specific study, assessing their satisfaction with the diabetes management, with a focus on glucose monitoring methods. RESULTS:Overall satisfaction with the diabetes treatment during hospitalisation was similar in both groups, with 77% of patients in each group reporting being satisfied or very satisfied (p = 0.188). Regarding glucose assessment, 75% in the CGM group preferred CGM over POC glucose testing (p < 0.001). In the CGM group, 95% felt comfortable with CGM being the primary method for glucose management (p < 0.001). Approximately 5% reported discomfort from wearing the CGM, mainly due to itching from the sensor. Most patients (95%) in both groups were comfortable with their diabetes management being handled by inpatient diabetes teams (p < 0.001). CONCLUSIONS:Satisfaction with CGM among non-ICU patients with type 2 diabetes managed by inpatient diabetes teams was high, highlighting CGM's potential to enhance patient care in the hospital setting.

Aims: Stress-induced hyperglycaemia can exacerbate existing diabetes. However, the relationship between inpatient inflammation and glucose levels is not well understood. Materials and Methods: This post hoc analysis utilised data from the DIATEC trial (N = 166), a two-arm randomised controlled trial comparing glucose management with real-time continuous glucose monitoring (CGM) or point-of-care glucose testing in non-intensive care unit (non-ICU) patients with type 2 diabetes treated with a basal-bolus insulin regimen. Inflammation was measured as C-reactive protein (CRP) levels daily, and its association with daily glycaemic outcomes and insulin doses was assessed. Results: For every 100 mg/dL increase in CRP, time in range 3.9-10.0 mmol/L (70-180 mg/dL) decreased by 3.6%-points (95% CI: 1.2-6.1, p = 0.004). An interaction was found between high CRP (>75.0 mg/dL) and high HbA1c (>51.0 mmol/mol or 6.8%), associated with an 8.9%-point reduction in TIR (95% CI: 3.8-14.1). Time above range >10.0 mmol/L (>180 mg/dL) increased by 3.3%-points (95% CI: 0.8-5.8, p = 0.009), and mean glucose increased by 0.2 mmol/L (95% CI: 0.02-0.4) (4.0 mg/dL, 95% CI: 0.4-7.0) for every 100 mg/dL increase in CRP. No significant associations were found between CRP and time below range <3.9 mmol/L (<70 mg/dL), glycaemic variability, hypoglycaemic events, or total daily insulin dose (all p > 0.05). Conclusions: Elevated CRP levels only modestly increased glucose levels. This suggests that inflammation during hospitalisation has a limited effect on glucose levels in non-ICU patients with type 2 diabetes.

Objective:The aim of this study was to investigate the use of nonbarrier contraceptives among women with HIV (WWH) compared to women from the general population (WGP) in Denmark.Design:A nationwide, population-based, matched cohort study.Methods:We included WWH aged 16-50 years, treated at an HIV specialized clinic, and included in The Danish HIV Cohort Study between 1995 and 2021 and an age-matched comparison cohort of WGP. We examined use of hormonal contraception, intrauterine devices (IUDs), and sterilization from 10 years before to 20 years after study inclusion. Additionally, we calculated age-standardized proportions and incidences over calendar time.Results:We included 1720 WWH and 17 720 WGP. Median age was 33 years and almost half of WWH had African origin (41%). Nonbarrier contraceptive use was lower among WWH (8.5%) compared to WGP (32.1%) at study inclusion. Before and after inclusion, WWH had nearly half the nonbarrier contraceptive use of WGP, with notably lower hormonal contraception and IUD use. Initially, fewer WWH were sterilized, but 5 years after inclusion, sterilization became the preferred method among WWH. HC use increased among WWH after 2010 but decreased among WGP after 2005. IUD use increased among both groups during 1995-2021 but remained lower among WWH. Incidence of sterilizations remained stable in both groups.Conclusion:Use of nonbarrier contraceptives was lower among WWH compared to WGP. For WWH, sterilization became the preferred nonbarrier method few years after study inclusion. hormonal contraception and IUD use increased among WWH after 2010 but remained lower than for WGP. Improved contraceptive counseling is recommended to support reproductive health among WWH.

OBJECTIVE The Diabetes Team and CGM in Managing Hospitalized Patients With Diabetes (DIATEC) trial investigates the glycemic and clinical effects of inpatient continuous glucose monitoring (CGM)-guided insulin titration by diabetes teams. RESEARCH DESIGN AND METHODS This two-center trial randomized 166 non-intensive care unit patients with type 2 diabetes. Diabetes management was performed by regular staff, guided by diabetes teams using insulin titration algorithms based on either point-of-care glucose testing or CGM. The primary outcome was the difference in time in range (TIR) (3.9-10.0 mmol/L) between the two arms. Outcomes were assessed during hospitalization. RESULTS The CGM arm achieved a higher median (interquartile range [IQR]) TIR of 77.6% (24.4%) vs. 62.7% (31.5%) in the POC arm (P < 0.001). Median (IQR) time above range (TAR) >10.0 mmol/L was lower in the CGM arm at 21.1% (24.8%) vs. 36.5% (30.3%) in the POC arm (P = 0.001), and time below range (TBR) <3.9 mmol/L was reduced by CGM, with a relative difference to POC of 0.57 (95% CI 0.34-0.97; P = 0.042). Prolonged hypoglycemic events decreased (incidence rate ratio [IRR] 0.13; 95% CI 0.04-0.46; P = 0.001), and the mean (SD) coefficient of variation was lower in the CGM arm at 25.4% (6.3%) vs. 28.0% (8.2%) in the POC arm (P = 0.024). Mean (SD) total insulin doses were reduced in the CGM arm at 24.1 (13.9) vs. 29.3 (13.9) IU/day in the POC arm (P = 0.049). A composite of complications was lower in the CGM arm (IRR 0.76; 95% CI 0.59-0.98; P = 0.032). CONCLUSIONS In-hospital CGM increased TIR by 15 percentage points, mainly by reducing TAR. CGM also lowered TBR, glycemic variability, prolonged hypoglycemic events, insulin usage, and in-hospital complications.

AimsUnderstanding whether improved glycaemic outcomes from continuous glucose monitoring (CGM) compared to point-of-care (POC) glucose testing apply uniformly to all hospitalised non-intensive care unit (non-ICU) patients with type 2 diabetes or vary among subgroups is crucial for allocating healthcare resources.Materials and MethodsThis two-site randomised controlled trial DIAbetes TEam and Cgm (DIATEC) enrolled 166 non-ICU patients with type 2 diabetes. Diabetes management was based on either POC glucose testing or CGM. Diabetes management was carried out by general hospital staff, under the guidance of specialised diabetes teams, using insulin titration protocols in both groups. We conducted heterogeneity of treatment effect regression analyses to assess whether certain patient characteristics (e.g., age, gender, haemoglobin A1c, etc.) modified the effects of CGM, compared to POC glucose testing, on the glycaemic outcomes time in/above/below range, mean glucose level, standard deviation (SD), coefficient of variation (CV) and hypoglycaemic events.ResultsNo heterogeneity of treatment effect was observed, suggesting that all patients benefited equally from CGM compared to POC glucose testing regarding glycaemic outcomes.ConclusionsFrom a glycaemic perspective, CGM could be widely recommended for most non-ICU patients with type 2 diabetes, as its glycaemic benefits over POC glucose testing appear consistent regardless of individual characteristics.

Background Pre-exposure prophylaxis (PrEP) effectively prevents HIV, but its association with sexually transmitted infections (STIs) has raised concerns about risk compensation, potentially impacting the expansion of PrEP programmes. Aim We examined the relationship between PrEP and the incidence of chlamydia, gonorrhoea and syphilis. Methods In this prospective cohort study, we compared STI rates before and after PrEP initiation among users in the capital region of Denmark (2019–2022), calculating incidence rate ratios adjusted for age and testing frequency (aIRR). To pinpoint when increases began, we plotted weekly STI rates, adjusting the timeline to correspond with PrEP initiation. Results The study included 1,326 PrEP users with a median age of 35 years. The STI incidence rate per 100,000 person-years rose from 35.3 before to 81.2 after PrEP start, with an aIRR of 1.35 (95% CI: 1.18–1.56). Notably, this increase preceded PrEP initiation by 10–20 weeks. Specific aIRR for chlamydia, gonorrhoea and syphilis were 1.23 (95% CI: 1.03–1.48), 1.24 (95% CI: 1.04–1.47) and 1.15 (95% CI: 0.76–1.72), respectively. In subanalyses for anatomical sites aIRR was 1.26 (95% CI: 1.01–1.56) for rectal chlamydia and 0.66 (95% CI: 0.45–0.96) for genital gonorrhoea. Conclusion We found a 35% increase in STI incidence associated with PrEP use. It started before PrEP initiation, challenging the assumption that PrEP leads to risk compensation. Instead, the data suggest that individuals seek PrEP during periods of heightened sexual risk-taking. Consequently, PrEP programmes should include sexual health consultations, STI testing, treatment and prevention strategies to prevent HIV and improve sexual health.

Background Survival among people with HIV (PWH) has vastly improved globally over the last few decades but remains lower than among the general population. We aimed to estimate time trends of survival among PWH and their families from 1995 to 2021. Methods We conducted a registry-based, nationwide, population-based, matched cohort study. We included all Danish-born PWH from 1995 to 2021 who had been on antiretroviral therapy for 90 days, did not report intravenous drug use, and were not co-infected with hepatitis C (n = 4168). We matched population controls from the general population 10:1 to PWH by date of birth and sex (n = 41,680). For family cohorts, we identified siblings, mothers, and fathers of PWH and population controls. From Kaplan-Meier tables with age as time scale, we estimated survival from age 25. We compared PWH with population controls and families of PWH with families of population controls to calculate mortality rate ratios adjusted for sex, age, comorbidities, and education (aMRR). Findings The median age of death among PWH increased from 27.5 years in 1995-1997 to 73.9 years (2010-2014), but thereafter survival increased only marginally. From 2015 to 2021, mortality was increased among PWH (aMRR 1.87 (95% CI: 1.65-2.11)) and siblings (aMRR: 1.25 (95% CI: 1.07-1.47)), mothers (aMRR: 1.30 (95% CI: 1.17-1.43)), and fathers (aMRR: 1.15 (95% CI: 1.03-1.29)) of PWH compared to their respective control cohorts. Mortality among siblings of PWH who reported heterosexual route of HIV transmission (aMRR: 1.51 (95% CI: 1.16-1.96)) was higher than for siblings of PWH who reported men who have sex with men as route of HIV transmission (aMRR 1.19 (95% CI: 0.98-1.46)). Interpretation Survival among PWH improved substantially until 2010, after which it increased only marginally. This may partly be due to social and behavioural factors as PWH families also had higher mortality.

Introduction Prolonged use of antibiotics is closely related to antibiotic-associated infections, antimicrobial resistance and adverse drug events. The optimal duration of antibiotic treatment for Gram-negative bacteremia (GNB) with a urinary tract source of infection is poorly defined. Methods and analysis Investigator-initiated multicentre, non-blinded, non-inferiority randomised controlled trial with two parallel treatment arms. One arm will receive shortened antibiotic treatment of 5 days and the other arm will receive antibiotic treatment of 7 days or longer. Randomisation will occur in equal proportion (1:1) no later than day 5 of effective antibiotic treatment as determined by antibiogram. Immunosuppressed patients and those with GNB due to non-fermenting bacilli (Acinetobacter spp, Pseudomonas spp), Brucella spp, Fusobacterium spp or polymicrobial growth are ineligible. The primary endpoint is 90-day survival without clinical or microbiological failure to treatment. Secondary endpoints include all-cause mortality, total duration of antibiotic treatment, hospital readmission and Clostridioides difficile infection. Interim safety analysis will be performed after the recruitment of every 100 patients. Given an event rate of 12%, a non-inferiority margin of 10%, and 90% power, the required sample size to determine non-inferiority is 380 patients. Analyses will be performed on both intention-to-treat and per-protocol populations. Ethics and dissemination The study is approved by the Danish Regional Committee on Health Research (H-19085920) and the Danish Medicines Agency (2019-003282-17). The results of the main trial and each of the secondary endpoints will be submitted for publication in a peer-reviewed journal. Trial registration number ClinicalTrials.Gov:NCT04291768.

Objective: To compare the risk of a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test and coronavirus disease 2019 (COVID-19) outcomes in people with HIV (PWH) with the general population, and estimate the association with vaccination status. Design: A nationwide, population based, matched cohort study Methods: We included all Danish PWH ≥18 years (n = 5276) and an age and sex-matched general population cohort (n = 42 308). We used Cox regression analyses to calculate (adjusted) incidence rate ratios [(a)IRR] and further stratified and restricted the analyses. Results: We observed no major difference in risk of first positive SARS-CoV-2 test [aIRR: 0.8 (95% confidence interval (CI): 0.8–0.9)], but a higher risk of first hospital contact with COVID-19 and hospitalization with severe COVID-19 for PWH vs. controls [IRR: 2.0; (1.6–2.5), 1.8 (1.4–2.3)]. Risk of first hospitalization decreased substantially in PWH with calendar time [first half of year 2022 vs. 2020 IRR: 0.3; (0.2–0.6)], whereas the risk compared to population controls remained almost twofold increased. We did not observe increased risk of death after SARS-CoV-2 infection [aIRR: 0.7 (95% CI: 0.3–2.0)]. Compared to PWH who had received two vaccines PWH who receiving a third vaccine had reduced risk of first positive SARS-CoV-2 test, death (individuals ≥60years) and hospitalization [aIRR: 0.9 (0.7–1.0); 0.2 (0.1–0.7); 0.6 (0.2–1.2)]. Conclusion: PWH have almost the same risk of a positive SARS-CoV-2 test as the general population. Although risk of hospital contacts and severe outcomes following SARS-CoV-2 infection is increased, the risk of death does not seem to be substantially increased. Importantly, a third vaccine is associated with reduced risk of infection, and death.

BACKGROUND Reproductive health in women with HIV (WWH) has improved in recent decades. We aimed to investigate incidences of childbirth, pregnancy, spontaneous abortion, and induced abortion among WWH in a nationwide, population-based, matched cohort study. METHODS We included all WWH aged 20 to 40 treated at an HIV healthcare centre in Denmark from 1995-2021, and a matched comparison cohort of women from the general population (WGP). We calculated incidence rates per 1,000 person years and used Poisson regression to calculate adjusted incidence rate ratios (aIRR) of childbirth, pregnancy, spontaneous abortion, and induced abortion stratified according to calendar periods (1995-2001, 2002-2008, and 2009-2021). RESULTS We included 1,288 WWH and 12,880 WGP. 46% of WWH were of African origin whereas 1% of WGP were of African origin. Compared to WGP, WWH had a decreased incidence of childbirth (aIRR: 0.6, 95% CI: 0.6-0.7), no difference in incidence of pregnancy (aIRR: 0.9, 95% CI: 0.8-1.0) or spontaneous abortion (aIRR: 0.9, 95% CI: 0.8-1.0), but an increased incidence of induced abortion (aIRR: 1.9, 95% CI: 1.6-2.1) from 1995-2021. The aIRR of childbirth, pregnancy, and spontaneous abortion increased from 1995-2000 to 2009-2021, while the aIRR of induced abortion remained increased across all time-periods for WWH. CONCLUSION From 1995-2008, incidences of childbirth, pregnancy, and spontaneous abortion were decreased among WWH compared to WGP. From 2009-2021, the incidence of childbirth, pregnancy, and spontaneous abortion no longer differed among WWH compared with WGP. The incidence of induced abortions remains increased among WWH.

Background Migrants face an increased risk of HIV infection and late presentation for HIV care. Aim To examine delays in HIV diagnosis, linkage to care (LTC), and risk of late presentation for migrants living with HIV in Denmark. Methods We conducted a population-based, nationwide study of adult migrants (n = 2,166) presenting for HIV care between 1 January 1995 and 31 December 2020 in Denmark. Time from immigration to HIV diagnosis and from diagnosis to LTC, and late presentation were assessed, stratified by migrants’ geographical regions of origin, using descriptive statistics. Results The demographics of the migrant population changed over time. Overall, migrants diagnosed with HIV after immigration to Denmark resided a median of 3.7 (IQR: 0.8–10.2) years in Denmark before diagnosis. Median time from HIV diagnosis to LTC was 6 (IQR: 0–24) days. Migrants diagnosed with HIV infection before immigration had a median of 38 (IQR: 0–105) days from arrival in Denmark to LTC. The corresponding median times for 2015–20 alone were 4.1 (IQR: 0.9–13.1) years, 0 (IQR: 0–8) days, and 62 (IQR: 25–152) days, respectively. The overall proportion of late presentation among migrants diagnosed with HIV after immigration was 60%, and highest among migrants from sub-Saharan Africa and East and South Asia. Conclusion HIV diagnosis is still substantially delayed in Danish migrants, while LTC is timely. The proportions with late presentation are high. These results call for targeted interventions to reduce the number of migrants with undiagnosed HIV infections and of late presenters.

Background and aims To evaluate the ability of pretreatment liver stiffness measurements (pLSM) to predict hepatocellular carcinoma (HCC), incident decompensation and all-cause mortality in chronic hepatitis C (CHC) patients who achieved sustained virological response (SVR) after treatment with direct-acting antivirals (DAAs). Methods 773 CHC patients with SVR after DAA treatment and no prior liver complications were identified retrospectively. Optimized cut-off of 17.5 kPa for incident HCC was selected by maximum Youden’s index. Patients were grouped by pLSM: <10 kPa [reference], 10–17.4 kPa and ≥17.5 kPa. Primary outcomes were incident hepatocellular carcinoma and secondary outcomes were incident decompensated cirrhosis and all-cause mortality, analyzed using cox-regression. Results Median follow-up was 36 months and 43.5% (336) had cirrhosis (LSM>12.5 kPa). The median pLSM was 11.6 kPa (IQR 6.7–17.8, range 2.5–75) and pLSM of <10 kPa, 10–17.4 kPa and 17.5–75 kPa was seen in 41.5%, 32.2% and 26.3%. During a median follow-up time of 36 months, 11 (1.4%) developed HCC, 14 (1.5%) developed decompensated cirrhosis, and 38 (4.9%) patients died. A pLSM of 17.5 kPa identified patients with a high risk of HCC with a negative predictive value of 98.9% and incidence rate of HCC in the 17.5–75 kPa group of 1.40/100 person years compared to 0.14/100 person years and 0.12/100 person years in the 10–17.4 kPa and <10 kPa groups, p<0.001. Conclusion Pretreatment LSM predicts risk of HCC, decompensation and all-cause mortality in patients with SVR after DAA treatment. Patients with a pLSM <17.5 kPa and no other risk factors for chronic liver disease appear not to benefit from HCC surveillance for the first 3 years after treatment. Longer follow-up is needed to clarify if they can be safely excluded from post treatment HCC screening hereafter.

Case-fatality rates in Ebola treatment centers (ETCs) varied widely during the Ebola virus disease (EVD) outbreak in West Africa. We assessed the influence of referral pathway on ETC case-fatality rates with a retrospective cohort of 126 patients treated at the Mathaska ETC in Port Loko, Sierra Leone. The patients consisted of persons who had confirmed EVD when transferred to the ETC or who had been diagnosed onsite. The case-fatality rate for transferred patients was 46% versus 67% for patients diagnosed onsite (p = 0.02). The difference was mediated by Ebola viral load at diagnosis, suggesting a survival selection bias. Comparisons of case-fatality rates across ETCs and clinical management strategies should account for potential survival selection bias.

Background. Knowledge about mortality rates (MRs) in patients with chronic hepatitis C (CHC) with cirrhosis is limited. This study aimed to estimate all-cause MRs among patients with CHC with or without cirrhosis in Denmark compared with the general population.Methods. Patients registered in the Danish Database for Hepatitis B and C with CHC and a liver fibrosis assessment were eligible for inclusion. Liver fibrosis was assessed by means of liver biopsy, transient elastography, and clinical cirrhosis. Up to 20 sex-and age-matched individuals per patient were identified in the general population. Data were extracted from nationwide registries.Results. A total of 3410 patients with CHC (1014 with cirrhosis), and 67 315 matched individuals were included. Adjusted MR ratios (MRRs) between patients with or without cirrhosis and their comparison cohorts were 5.64 (95% confidence interval [ CI], 4.76-6.67) and 1.94 (1.55-2.42), respectively. Cirrhosis among patients was associated with an MRR of 4.03 (95% CI, 3.43-4.72). A cure for CHC was associated with an MRR of 0.64 (95% CI, 0.40-1.01) among cirrhotic patients and 2.33 (1.47-3.67) compared with the general population.Conclusions. MRs were high among patients with CHC with or without cirrhosis compared with the general population. Curing CHC was associated with a reduction in MR among cirrhotic patients, but the MR remained higher than the general population.