HBV genotype C is independently associated with cirrhosis in community-based population

查看全文 作　　者：Yin, Jian-[1]Hua;Zhao, [2]Jun;Zhang, Hong-[1]Wei;Xie, Jia-[1]Xin;Li, Wei-[3]Ping;Xu, Guo-[4]Zhang;Shen, [5]Jie;Dong, Hong-[4]Jun;Zhang, [5]Jun;Wang, [6]Lin;Han, Jian-[7]Kang;Wang, Hong-[8]Yang;Cao, Guang-[1]Wen 机构地区：[1]Second Mil Med Univ, Dept Epidemiol, Shanghai 200433, Peoples R China;[2]Second Mil Med Univ, Affiliated Hosp 3, Dept Hepatobiliary Surg, Shanghai 200438, Peoples R China;[3]Second Mil Med Univ, Dept Ultrasonog, Affiliated Hosp 1, Shanghai 200433, Peoples R China;[4]Municipal Ctr Dis Control & Prevent Ningbo, Ningbo 315010, Zhejiang, Peoples R China;[5]Municipal Ctr Dis Control & Prevent Soochow, Suzhou 215007, Jiangsu, Peoples R China;[6]Dist Ctr Dis Control & Prevent Yangpu, Shanghai 200090, Peoples R China;[7]Municipal Ctr Dis Control & Prevent Huzhou, Huzhou 313000, Zhejiang, Peoples R China;[8]Second Mil Med Univ, Lab Signal Transduct, Affiliated Hosp 3, Shanghai 200438, Peoples R China 出　　处：《World Journal of Gastroenterology》索引2010年第16卷第3期,共5页 基　　金：Supported by Ministry of Health of China,No.2008ZX10002-15;National Natural Science Foundation of China,No.30921006;Shanghai Science & Technology Committee,No.08XD14001;Shanghai Heath Bureau of Health,No.08GWD02 and 08GWZX0201 摘　　要：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 asso-ciated 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. 关 键 词：Hepatitis B virus GENOTYPE Viral load Alanine aminotransferase Probable cirrhosis ULTRASONOGRAPHY