HBV 基因型 C 与社区人群中的肝硬化独立相关。
HBV genotype C is independently associated with cirrhosis in community-based population.
机构信息
Department of Epidemiology, Second Military Medical University, 800 Xiangyin Rd., Shanghai 200433, China.
出版信息
World J Gastroenterol. 2010 Jan 21;16(3):379-83. doi: 10.3748/wjg.v16.i3.379.
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 > or = 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 (> or = 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.
目的
确定乙型肝炎病毒（HBV）基因型与社区人群中肝硬化和脂肪肝的相关性。
方法
采用多阶段聚类概率抽样方法，从中国东部的流行病学基地招募了 10167 名年龄在 6 至 72 岁之间的 HBsAg 阳性受试者。排除同时感染丙型肝炎或丁型肝炎病毒的受试者后，对 HBV 表面抗原（HBsAg）阳性的受试者进行 HBV 基因型、血清病毒载量、丙氨酸氨基转移酶（ALT）、乙型肝炎 e 抗原（HBeAg）状态和超声变化检查。使用逻辑回归模型确定与肝硬化和脂肪肝相关的因素。
结果
在确定了 HBV 基因型的 634 名 HBsAg 阳性受试者中，82 名患有肝硬化（超声评分>或=5），42 名患有超声脂肪肝。肝硬化仅见于 HBeAg 阴性受试者，且 C 基因型的发生率高于 B 基因型（14.8%比 8.0%，P=0.018）。在 HBeAg 阴性受试者中，高病毒载量常与异常 ALT 水平相关，而异常 ALT 更常见于肝硬化患者（19.5%比 7.8%，P=0.001）。单因素分析显示，年龄、性别、HBV 基因型和病毒载量与超声脂肪肝无显著相关性，而 ALT 异常与超声脂肪肝显著相关（OR=4.54，95%CI：2.11-9.75，P<0.001）。多因素分析表明，HBV 基因型 C、年龄（>或=45 岁）、男性和 ALT 异常与肝硬化独立相关（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）。
结论
在社区 HBV 感染人群中，肝硬化的粗患病率为 12.9%。在 HBeAg 阴性受试者中，HBV 基因型 C 与肝硬化独立相关。
Zotero 插件