丙型和乙型肝炎病毒感染对慢性肝炎发生的独立和累加效应修饰作用。

Independent and additive effect modification of hepatitis C and B viruses infection on the development of chronic hepatitis.

作者信息

Tsai J F, Jeng J E, Ho M S, Chang W Y, Lin Z Y, Tsai J H

机构信息

Department of Internal Medicine, Kaohsiung Medical College, Taiwan, Republic of China.

出版信息

J Hepatol. 1996 Mar;24(3):271-6. doi: 10.1016/s0168-8278(96)80004-3.

DOI:10.1016/s0168-8278(96)80004-3

PMID:8778192

Abstract

BACKGROUND/AIMS: This study aimed to assess the effects and interaction between hepatitis B virus and hepatitis C virus infection on the development of chronic hepatitis.

METHODS

Anti-HCV and HBsAg were detected in 125 histology-proven chronic hepatitis and 250 sex-matched and age-matched healthy controls.

RESULTS

The prevalences of anti-HCV (24.8%) and HBsAg (68.0%) in patients were higher than in controls (2.4% and 18.0%, respectively; each p < 0.0001). Univariate analysis showed that anti-HCV and HBsAg were strongly associated with the development of chronic hepatitis. Calculation of synergy index and Mantel extension test for trend indicated that there was additive effect modification between HCV and HBV. Multivariate analysis indicated that anti-HCV (odds ratio, 46.1; 95% confidence interval, 9.1-233.2) and HBsAg (odds ratio, 25.8; 95% confidence interval (9.3-67.2) were independent risk factors of chronic hepatitis. The population-attributable risk was estimated as 15.6% for anti-HCV alone, 52.4% for HBsAg alone and 6.8% for both anti-HCV and HBsAg. The frequency of chronic active hepatitis in patients with anti-HCV alone (100%) was higher than in patients with HBsAg alone (75%, p < 0.001).

CONCLUSIONS

HCV and HBV infections are risk factors of chronic hepatitis. They act independently and probably with additive effect modification.

摘要

背景/目的：本研究旨在评估乙型肝炎病毒和丙型肝炎病毒感染对慢性肝炎发展的影响及相互作用。

方法

在125例经组织学证实的慢性肝炎患者以及250例性别和年龄匹配的健康对照者中检测抗-HCV和HBsAg。

结果

患者中抗-HCV（24.8%）和HBsAg（68.0%）的患病率高于对照组（分别为2.4%和18.0%；p均<0.0001）。单因素分析显示，抗-HCV和HBsAg与慢性肝炎的发生密切相关。协同指数计算及趋势的Mantel扩展检验表明，HCV和HBV之间存在相加效应修正。多因素分析表明，抗-HCV（比值比，46.1；95%置信区间，9.1 - 233.2）和HBsAg（比值比，25.8；95%置信区间(9.3 - 67.2)）是慢性肝炎的独立危险因素。单独抗-HCV的人群归因风险估计为15.6%，单独HBsAg为52.4%，抗-HCV和HBsAg两者均有的为6.8%。单独抗-HCV患者中慢性活动性肝炎的发生率（100%）高于单独HBsAg患者（75%，p<0.001）。