酒精摄入、乙型肝炎病毒和丙型肝炎病毒相互作用对肝硬化风险的性别差异。

Sex difference in the interaction of alcohol intake, hepatitis B virus, and hepatitis C virus on the risk of cirrhosis.

作者信息

Stroffolini Tommaso, Sagnelli Evangelista, Andriulli Angelo, Colloredo Guido, Furlan Caterina, Gaeta Giovanni Battista, Morisco Filomena, Pirisi Mario, Rosina Floriano, Sagnelli Caterina, Smedile Antonina, Almasio Piero Luigi

机构信息

Department of Tropical and Infectious Diseases, Policlinico Umberto I, Rome, Italy.

Department of Mental Health and Public Medicine, Campania University Luigi Vanvitelli, Naples, Italy.

出版信息

PLoS One. 2017 Nov 15;12(11):e0185710. doi: 10.1371/journal.pone.0185710. eCollection 2017.

DOI:10.1371/journal.pone.0185710

PMID:29140988

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5687716/

Abstract

BACKGROUND

The joint effect of the interaction of alcohol intake, hepatitis B virus (HBV) and hepatitis C virus (HCV) on the risk of cirrhosis is still unexplored because a large sample size is required for this investigation.

OBJECTIVE

Evaluation of interaction of HBV, HCV and alcohol abuse on the risk of cirrhosis.

DESIGN

We analysed 12,262 consecutive patients with chronic liver disease of various aetiologies referring to 95 Italian liver units in 2001 or 2014. To evaluate the interaction between alcohol abuse, HBV infection, and HCV infection, patients unexposed to either factors were used as reference category. Adjustment for BMI and age was done by multiple logistic regression analysis.

RESULTS

Females were older than males (p<0.01) and less frequently showed HBV and alcoholic aetiology (p<0.01). In both sexes, an overtime increasing age and an increasing proportion of subjects with liver cirrhosis was observed, reflecting a better survival (0.01). An additive interaction is observed in females: the O.R. generated by the simultaneous presence of HBV, HCV, and alcohol (5.09; 95% C.I. 1.06-24.56) exceeds the sum (4.14) of the O.R. generated by a single exposure (O.R. = 0.72 for HBsAg positivity, OR = 1.34 for anti-HCV positivity, and O.R. = 2.08 for alcohol intake). No interaction is observed in male sex.

CONCLUSIONS

The observed gender difference suggests that the simultaneous presence of HBV/HCV coinfection and risky alcohol intake enhances the mechanism of liver damage to a greater extent in females than in males.

摘要

背景

由于该研究需要大样本量，酒精摄入、乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）相互作用对肝硬化风险的联合影响仍未得到探索。

目的

评估HBV、HCV和酒精滥用对肝硬化风险的相互作用。

设计

我们分析了2001年或2014年转诊至意大利95个肝病科的12262例连续的各种病因慢性肝病患者。为了评估酒精滥用、HBV感染和HCV感染之间的相互作用，将未接触任何一种因素的患者作为参照组。通过多元逻辑回归分析对体重指数和年龄进行校正。

结果

女性比男性年龄大（p<0.01），且HBV和酒精性病因的发生率较低（p<0.01）。在两性中，均观察到年龄随时间增加以及肝硬化患者比例增加，这反映了更好的生存率（p=0.01）。在女性中观察到相加相互作用：HBV、HCV和酒精同时存在时产生的比值比（5.09；95%可信区间1.06-24.56）超过单次暴露产生的比值比之和（4.14）（HBsAg阳性时比值比=0.72，抗-HCV阳性时比值比=1.34，酒精摄入时比值比=2.08）。在男性中未观察到相互作用。