Department of Ophthalmology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.
School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan.
Acta Ophthalmol. 2019 Aug;97(5):e713-e718. doi: 10.1111/aos.14032. Epub 2019 Jan 28.
To study the association between chronic hepatitis B virus (HBV) and age-related macular degeneration (AMD).
Data used in this retrospective, frequency-matched cohort study were acquired from the Longitudinal Health Insurance Database 2000, which includes medical claims and registration files for 1 000 000 enrolees in the Taiwan National Health Insurance programme. The HBV cohort contained 17 796 patients who received a diagnosis of chronic HBV infection between January 1, 2000 and December 31, 2012. The non-HBV cohort contained 71 184 participants who were frequency-matched by age, sex and year of index date for comparison. Participants were followed until the end of 2013, and those who developed AMD during the study period were identified. A Cox proportional hazards regression model was used to compare the risk of AMD between cohorts.
The incidence of any type of AMD in all participants was 3.88 per 1000 person-years (PY; 2.27 per 1000 PY in the HBV cohort; 1.61 per 1000 PY in the non-HBV cohort). Compared with the non-HBV cohort, the adjusted hazard ratio (HR) for any type of AMD in the HBV cohort was 1.41 [95% confidence interval (CI) 1.23-1.63; p < 0.001]. This significant positive association was stronger among patients who exhibited disease progression from nonexudative to exudative AMD (adjusted HR = 1.74, 95% CI: 1.01-2.99).
Our results suggest that patients with chronic HBV infection in Taiwan have a significantly elevated risk of developing any type of AMD and that HBV infection may accelerate the progression of AMD.
研究慢性乙型肝炎病毒(HBV)与年龄相关性黄斑变性(AMD)之间的关系。
本回顾性、频率匹配队列研究的数据来自于 2000 年纵向健康保险数据库,该数据库包含台湾全民健康保险计划 100 万参保者的医疗索赔和登记文件。HBV 队列包含 17796 名在 2000 年 1 月 1 日至 2012 年 12 月 31 日期间确诊为慢性 HBV 感染的患者。非 HBV 队列包含 71184 名参与者,他们通过年龄、性别和索引日期的年份进行频率匹配以进行比较。参与者被随访至 2013 年底,期间确定了 AMD 发病的患者。使用 Cox 比例风险回归模型比较队列间 AMD 的发病风险。
所有参与者的任何类型 AMD 的发生率为每 1000 人年 3.88 例(HBV 队列中为每 1000 人年 2.27 例;非 HBV 队列中为每 1000 人年 1.61 例)。与非 HBV 队列相比,HBV 队列中任何类型 AMD 的调整后风险比(HR)为 1.41(95%置信区间[CI] 1.23-1.63;p<0.001)。在从非渗出性 AMD 进展为渗出性 AMD 的患者中,这种显著的正相关关系更强(调整 HR=1.74,95%CI:1.01-2.99)。
我们的结果表明,台湾慢性 HBV 感染患者发生任何类型 AMD 的风险显著升高,并且 HBV 感染可能会加速 AMD 的进展。