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Chronic hepatitis B virus infection and total and cause-specific mortality: a prospective cohort study of 0.5 million people
OBJECTIVES: Chronic hepatitis B virus (HBV) infection is associated with a higher risk of liver diseases. Substantial uncertainty remains, however, about the associations of HBV infection with mortality from extrahepatic causes, especially from subtypes of cardiovascular diseases. We prospectively e...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6500223/ https://www.ncbi.nlm.nih.gov/pubmed/30967410 http://dx.doi.org/10.1136/bmjopen-2018-027696 |
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author | Si, Jiahui Yu, Canqing Guo, Yu Bian, Zheng Meng, Ruogu Yang, Ling Chen, Yiping Jin, Jianrong Liu, Jingchao Guo, Ziyan Chen, Junshi Chen, Zhengming Lv, Jun Li, Liming |
author_facet | Si, Jiahui Yu, Canqing Guo, Yu Bian, Zheng Meng, Ruogu Yang, Ling Chen, Yiping Jin, Jianrong Liu, Jingchao Guo, Ziyan Chen, Junshi Chen, Zhengming Lv, Jun Li, Liming |
author_sort | Si, Jiahui |
collection | PubMed |
description | OBJECTIVES: Chronic hepatitis B virus (HBV) infection is associated with a higher risk of liver diseases. Substantial uncertainty remains, however, about the associations of HBV infection with mortality from extrahepatic causes, especially from subtypes of cardiovascular diseases. We prospectively examined the association of chronic HBV infection with total and cause-specific mortality. DESIGN: Population-based prospective cohort study. SETTING: China Kadoorie Biobank in which participants from 10 geographically diverse areas across China were enrolled between 2004 and 2008. PARTICIPANTS: 475 801 participants 30–79 years of age without reporting major chronic diseases at baseline were enrolled. Hepatitis B surface antigen (HBsAg) was tested using an on-site rapid test strip at baseline. PRIMARY AND SECONDARY OUTCOME MEASURES: Total and cause-specific mortality. RESULTS: A total of 35 822 deaths were recorded during ~10 years of follow-up. In multivariable-adjusted analyses, compared with HBsAg-negative participants, HBsAg-positive participants had an increased risk of total mortality (HR=2.01, 95% CI: 1.91 to 2.12), which was higher in men (HR=2.16, 95% CI: 2.01 to 2.31) than in women (HR=1.74, 95% CI: 1.60 to 1.90). Presence of HBsAg was associated with increased mortality from liver cancer (1339 deaths, HR=13.95, 95% CI: 12.46 to 15.62), infections (410 deaths, HR=10.30, 95% CI: 8.21 to 12.94), digestive diseases (688 deaths, HR=6.83, 95% CI: 5.49 to 8.50), intracerebral haemorrhage (4077 deaths, HR=1.38, 95% CI: 1.14 to 1.68) and ischaemic heart diseases (4624 deaths, HR=1.31, 95% CI: 1.09 to 1.58). The positive association between HBsAg status and risk of death was stronger in participants younger than 50 years, smokers, physically active or non-hypertensive participants. CONCLUSIONS: Among Chinese adults, chronic HBV infection was associated with increased mortality from a range of hepatic and extrahepatic diseases. |
format | Online Article Text |
id | pubmed-6500223 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-65002232019-05-21 Chronic hepatitis B virus infection and total and cause-specific mortality: a prospective cohort study of 0.5 million people Si, Jiahui Yu, Canqing Guo, Yu Bian, Zheng Meng, Ruogu Yang, Ling Chen, Yiping Jin, Jianrong Liu, Jingchao Guo, Ziyan Chen, Junshi Chen, Zhengming Lv, Jun Li, Liming BMJ Open Epidemiology OBJECTIVES: Chronic hepatitis B virus (HBV) infection is associated with a higher risk of liver diseases. Substantial uncertainty remains, however, about the associations of HBV infection with mortality from extrahepatic causes, especially from subtypes of cardiovascular diseases. We prospectively examined the association of chronic HBV infection with total and cause-specific mortality. DESIGN: Population-based prospective cohort study. SETTING: China Kadoorie Biobank in which participants from 10 geographically diverse areas across China were enrolled between 2004 and 2008. PARTICIPANTS: 475 801 participants 30–79 years of age without reporting major chronic diseases at baseline were enrolled. Hepatitis B surface antigen (HBsAg) was tested using an on-site rapid test strip at baseline. PRIMARY AND SECONDARY OUTCOME MEASURES: Total and cause-specific mortality. RESULTS: A total of 35 822 deaths were recorded during ~10 years of follow-up. In multivariable-adjusted analyses, compared with HBsAg-negative participants, HBsAg-positive participants had an increased risk of total mortality (HR=2.01, 95% CI: 1.91 to 2.12), which was higher in men (HR=2.16, 95% CI: 2.01 to 2.31) than in women (HR=1.74, 95% CI: 1.60 to 1.90). Presence of HBsAg was associated with increased mortality from liver cancer (1339 deaths, HR=13.95, 95% CI: 12.46 to 15.62), infections (410 deaths, HR=10.30, 95% CI: 8.21 to 12.94), digestive diseases (688 deaths, HR=6.83, 95% CI: 5.49 to 8.50), intracerebral haemorrhage (4077 deaths, HR=1.38, 95% CI: 1.14 to 1.68) and ischaemic heart diseases (4624 deaths, HR=1.31, 95% CI: 1.09 to 1.58). The positive association between HBsAg status and risk of death was stronger in participants younger than 50 years, smokers, physically active or non-hypertensive participants. CONCLUSIONS: Among Chinese adults, chronic HBV infection was associated with increased mortality from a range of hepatic and extrahepatic diseases. BMJ Publishing Group 2019-04-09 /pmc/articles/PMC6500223/ /pubmed/30967410 http://dx.doi.org/10.1136/bmjopen-2018-027696 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Epidemiology Si, Jiahui Yu, Canqing Guo, Yu Bian, Zheng Meng, Ruogu Yang, Ling Chen, Yiping Jin, Jianrong Liu, Jingchao Guo, Ziyan Chen, Junshi Chen, Zhengming Lv, Jun Li, Liming Chronic hepatitis B virus infection and total and cause-specific mortality: a prospective cohort study of 0.5 million people |
title | Chronic hepatitis B virus infection and total and cause-specific mortality: a prospective cohort study of 0.5 million people |
title_full | Chronic hepatitis B virus infection and total and cause-specific mortality: a prospective cohort study of 0.5 million people |
title_fullStr | Chronic hepatitis B virus infection and total and cause-specific mortality: a prospective cohort study of 0.5 million people |
title_full_unstemmed | Chronic hepatitis B virus infection and total and cause-specific mortality: a prospective cohort study of 0.5 million people |
title_short | Chronic hepatitis B virus infection and total and cause-specific mortality: a prospective cohort study of 0.5 million people |
title_sort | chronic hepatitis b virus infection and total and cause-specific mortality: a prospective cohort study of 0.5 million people |
topic | Epidemiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6500223/ https://www.ncbi.nlm.nih.gov/pubmed/30967410 http://dx.doi.org/10.1136/bmjopen-2018-027696 |
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