Tsai Yao-Te, Fang Ku-Hao, Yang Yao-Hsu, Lin Meng-Hung, Chen Pau-Chung, Tsai Ming-Shao, Hsu Cheng-Ming
Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chia-Yi, Taiwan: No. 6, W. Sec., Jiapu Rd., Puzi City, Chiayi County 613, Taiwan, R.O.C.
Ear Nose Throat J. 2018 Oct-Nov;97(10-11):E19-E27.
Sudden sensorineural hearing loss (SSNHL) has significant impact on quality of life. It may result from viral infection, but the relationship between hepatitis B virus (HBV) infection and SSNHL remains uncertain. To investigate the risk of developing SSNHL in patients with HBV, we conducted a nationwide, population-based, retrospective cohort study from the Taiwan National Health Insurance Research Database. A total of 33,234 patients diagnosed with HBV infection and 132,936 control subjects without viral hepatitis were selected from claims made from 2000 to 2008. Each patient was followed for at least 5 years to identify new-onset SSNHL. Among the 166,170 patients, 279 patients (303,793 person-years) from the HBV cohort and 845 patients (1,225,622 person-years) from the control cohort were diagnosed with SSNHL. The incidence of SSNHL was 1.33-fold higher in the HBV group than in the control group (0.92 vs. 0.69 per 10,000 person-years), with an adjusted hazard ratio (HR) of 1.315 (95% confidence interval [CI] = 1.148 to 1.506) calculated using a Cox proportional hazard regression model. We also observed that HBV patients in the 50 to 64 years of age subgroup showed the highest incidence of SSNHL and the highest adjusted hazard ratio (HR = 2.367; 95% CI = 1.958 to 2.861). Patients with HBV infection had a higher risk of acquiring SSNHL than patients without viral hepatitis. For the early detection and timely treatment of SSNHL, clinicians should be aware of the increased risk of SSNHL in HBV patients and arrange auditory examinations for those complaining about acute hearing change.
突发性感音神经性听力损失(SSNHL)对生活质量有重大影响。它可能由病毒感染引起,但乙型肝炎病毒(HBV)感染与SSNHL之间的关系仍不确定。为了调查HBV患者发生SSNHL的风险,我们利用台湾国民健康保险研究数据库进行了一项全国性、基于人群的回顾性队列研究。从2000年至2008年的理赔记录中,共选取了33234例诊断为HBV感染的患者和132936例无病毒性肝炎的对照对象。对每位患者至少随访5年以确定新发的SSNHL。在这166170例患者中,HBV队列中有279例患者(303793人年),对照队列中有845例患者(1225622人年)被诊断为SSNHL。HBV组中SSNHL的发病率比对照组高1.33倍(每10000人年分别为0.92和0.69),使用Cox比例风险回归模型计算的调整后风险比(HR)为1.315(95%置信区间[CI]=1.148至1.506)。我们还观察到,50至64岁亚组的HBV患者SSNHL发病率最高,调整后风险比也最高(HR=2.367;95%CI=1.958至2.861)。与无病毒性肝炎的患者相比,HBV感染患者发生SSNHL的风险更高。为了早期发现和及时治疗SSNHL,临床医生应意识到HBV患者发生SSNHL的风险增加,并为那些抱怨急性听力变化的患者安排听力检查。