What is the morbidity and mortality associated with hypersensitivity pneumonitis (HP)?

Updated: Oct 08, 2020
  • Author: Caleb Hsieh, MD, MS; Chief Editor: John J Oppenheimer, MD  more...
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Answer

Morbidity and mortality in the United States is tracked closely by the Centers for Disease Control and Prevention (CDC) and the Work Related Lung Disease Surveillance System (eWoRLD). For a more in-depth analysis and breakdown of demographics, see Hypersensitivity Pneumonitis from the CDC Web site.

Morbidity and mortality of hypersensitivity pneumonitis varies widely based on type, duration, and severity of exposure. Genetic factors may also play a significant role. In general, acute hypersensitivity pneumonitis and subacute hypersensitivity pneumonitis without fibrotic changes respond completely or near completely to removal of the inciting exposure. Once fibrotic changes occur, however, prognosis is less favorable. [45, 46]

Rarely, patients may progress to chronic hypersensitivity pneumonitis despite exposure control and treatment. Similar to chronic hypersensitivity pneumonitis, emphysema develops initially with progression to irreversible pulmonary fibrosis. Survival at that point is similar to that observed in idiopathic pulmonary fibrosis (IPF). Pulmonary hypertension is seen in 20% of cases of chronic hypersensitivity pneumonitis and carries worse prognosis. [3]

From 2001-2010, there were 744 recorded deaths in the United States from hypersensitivity pneumonitis. Of these recorded deaths, 95.2% were white and 3% were black; 58.5% were male. This represents roughly 0.2-0.3 deaths per million, although this likely is an underrepresentation due to underreporting. [47]


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