Association between metabolic risk factors and the hepatitis B reactivation of inactive HBsAg carriers in Jiangsu province: a cohort study.
10.3760/cma.j.cn112338-20211203-00944
- Author:
Jian Fang XU
1
;
Jie JIANG
2
;
Li YANG
3
;
Jiao QIAN
2
;
Han WANG
4
;
Hai Ming CHEN
5
;
Hong Jian LIU
6
;
Ci SONG
7
;
Xin XU
7
;
Feng Cai ZHU
8
;
Li Guo ZHU
8
;
Xiang Jun ZHAI
2
Author Information
1. Department of Acute Infectious Diseases Control and Immunization Programmes, Danyang County Center for Disease Control and Prevention, Danyang 212310, China.
2. Major Project Executive Office, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China.
3. School of Public Health, Xiamen University, Xiamen 361102, China.
4. School of Public Health, Nanjing Medical University, Nanjing 210029, China.
5. Department of Infectious Disease Control, Zhangjiagang County Center for Disease Control and Prevention, Zhangjiagang 215600, China.
6. Major Project Executive Office, Taixing County Center for Disease Control and Prevention, Taixing 225400, China.
7. Collaborative Innovation Center For Cancer Personalized Medicine, Nanjing Medical University, Nanjing 210029, China.
8. Key Laboratory of Intestinal Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China.
- Publication Type:Journal Article
- MeSH:
Cohort Studies;
DNA, Viral;
Hepatitis B/epidemiology*;
Hepatitis B Surface Antigens;
Hepatitis B virus/genetics*;
Hepatitis B, Chronic/epidemiology*;
Humans;
Risk Factors;
Young Adult
- From:
Chinese Journal of Epidemiology
2022;43(8):1301-1308
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To analyze the impact of metabolic risk factors on the epidemiological characteristics of the reactivation of inactive HBsAg carriers (IHC) and provide effective intervention measures to standardize the management of chronic hepatitis B infections. Methods: Based on the chronic hepatitis B infection cohort established in 2010 in Jiangsu province, six follow-up visits from 2012 to 2020 were conducted to analyze the characteristics and influencing factors of the hepatitis B reactivation of IHC and the impact of metabolic risk factors, including obesity, high blood pressure, diabetes and hyperglycemia. Results: From 2012 to 2020, 2 527 IHC and 17 730 person-years were observed during a median follow-up period of 7.0 person-years. Ninety-eight cases of hepatitis B reactivation, with a cumulative reaction rate, was 3.9%, and the incidence density was 5.53/1 000 person-years. Multivariate Cox proportional risk regression analysis showed that age and baseline HBV DNA were independent risk factors of HBV reactivation. Compared with the patients ≥60 years, 40-49 age group (aHR=2.16, 95%CI:1.20-3.90) and 20-29 age group (aHR=5.48, 95%CI:2.07-14.48) were significantly associated with hepatitis B reactivation. Compared with the HBV DNA negative patients at baseline, the risk of hepatitis B reactivation was higher in the group with low HBV DNA level 100-1 999 IU/ml (aHR=1.67, 95%CI:1.11-2.52). Stratification analysis results showed that compared with those without metabolic risk factors, in the ≥50 age group, patients with ≥2 metabolic risk factors showed adjusted HR of 2.73 (95%CI:1.08-6.96). Conclusions: The risk of hepatitis B being reactive is the persistent existence of IHC in communities in Jiangsu province, especially young adults, low-level HBV DNA carriers, and IHC with ≥2 metabolic risk factors. Follow-up for these IHC should be strengthened to reduce the risk of disease progression by antiviral treatment at the right time.
