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©2010 Baishideng. All rights reserved
World J Gastroenterol. Jan 21, 2010; 16(3): 379-383
Published online Jan 21, 2010. doi: 10.3748/wjg.v16.i3.379
HBV genotype C is independently associated with cirrhosis in community-based population
Jian-Hua Yin, Jun Zhao, Hong-Wei Zhang, Jia-Xin Xie, Wei-Ping Li, Guo-Zhang Xu, Jie Shen, Hong-Jun Dong, Jun Zhang, Lin Wang, Jian-Kang Han, Hong-Yang Wang, Guang-Wen Cao
Jian-Hua Yin, Hong-Wei Zhang, Jia-Xin Xie, Guang-Wen Cao, Department of Epidemiology, Second Military Medical University, Shanghai 200433, China
Jun Zhao, Department of Hepatobiliary Surgery, the 3rd Affiliated Hospital, Second Military Medical University, Shanghai 200438, China
Wei-Ping Li, Department of Ultrasonography, the 1st Affiliated Hospital, Second Military Medical University, Shanghai 200433, China
Guo-Zhang Xu, Hong-Jun Dong, Municipal Center for Disease Control and Prevention of Ningbo, Ningbo 315010, Zhejiang Province, China
Jie Shen, Jun Zhang, Municipal Center for Disease Control and Prevention of Soochow, Soochow 215007, Jiangsu Province, China
Lin Wang, District Center for Disease Control and Prevention of Yangpu, Shanghai 200090, China
Jian-Kang Han, Municipal Center for Disease Control and Prevention of Huzhou, Huzhou 313000, Zhejiang Province, China
Hong-Yang Wang, Laboratory for Signal Transduction, the 3rd Affiliated Hospital, Second Military Medical University, Shanghai 200438, China
Author contributions: Yin JH, Zhao J and Zhang HW contributed equally to this work; Yin JH, Zhao J and Zhang HW were involved in experimental work and data analysis; Xie JX was involved in HBV genotyping; Li WP was responsible for ultrasonographic examination; Xu GZ, Shen J, Dong HJ, Zhang J, Wang L, and Han JK were responsible for field study; Wang HY provided partial financial support; Cao GW designed the study and wrote the manuscript.
Supported by Ministry of Health of China, No. 2008ZX10002-15; National Natural Science Foundation of China, No. 30921006; Shanghai Science & Technology Committee, No. 08XD14001; and Shanghai Heath Bureau of Health, No. 08GWD02 and 08GWZX0201
Correspondence to: Dr. Guang-Wen Cao, Professor of Medicine, Chairman, Department of Epidemiology, Second Military Medical University, 800 Xiangyin Rd., Shanghai 200433, China. gcao@smmu.edu.cn
Telephone: +86-21-81871060 Fax: +86-21-81871060
Received: November 6, 2009
Revised: December 2, 2009
Accepted: December 9, 2009
Published online: January 21, 2010
AIM: To determine the association of hepatitis B virus (HBV) genotypes with probable cirrhosis and fatty liver in community-based populations.
METHODS: A multi-stage cluster probability sampling method was applied to recruit 10 167 subjects aged between 6 and 72 years from our epidemiological bases in Eastern China. After excluding the subjects co-infected with hepatitis C or hepatitis D viruses, the hepatitis B surface antigen (HBsAg)-positive subjects were examined for HBV genotype, serum viral load, alanine aminotransferase (ALT), hepatitis B e antigen (HBeAg) status, and ultrasonographic changes. Logistic regression models were used to determine the factors associated with probable cirrhosis and fatty liver.
RESULTS: Of 634 HBsAg-positive subjects with HBV genotype determined, 82 had probable cirrhosis (ultrasonographic score ≥ 5), 42 had ultrasonographic fatty liver. Probable cirrhosis was only found in the HBeAg-negative subjects, and more frequently found in the subjects with genotype C than in those with genotype B (14.8% vs 8.0%, P = 0.018). In HBeAg-negative subjects, high viral load was frequently associated with abnormal ALT level, while ALT abnormality was more frequent in those with probable cirrhosis than those without (19.5% vs 7.8%, P = 0.001). Univariate analysis showed that age, sex, HBV genotypes, and viral load were not significantly associated with ultrasonographic fatty liver, whereas ALT abnormality was significantly related to ultrasonographic fatty liver (OR = 4.54, 95% CI: 2.11-9.75, P < 0.001). Multivariate analysis demonstrated that HBV genotype C, age (≥ 45 years), male sex, and ALT abnormality were independently associated with probable cirrhosis (AOR = 2.30, 95% CI: 1.26-4.19; AOR = 1.81, 95% CI: 1.10-2.99; AOR = 1.74, 95% CI: 1.03-2.95; AOR = 2.98, 95% CI: 1.48-5.99, respectively).
CONCLUSION: A crude prevalence of probable cirrhosis is 12.9% in the community-based HBV-infected subjects. HBV genotype C is independently associated with probable cirrhosis in the HBeAg-negative subjects.
