Prolonged infection with hepatitis B virus and association between low blood cholesterol concentration and liver cancer.
OBJECTIVE
To determine whether prolonged infection with hepatitis B virus is associated with a lower blood cholesterol concentration.


METHODS
Cross sectional study.


METHODS
81 villages in rural China with a high prevalence of chronic infection with hepatitis B virus.


METHODS
1556 apparently healthy men aged 35-64 years, randomly selected.


METHODS
Hepatitis B virus carrier state; plasma concentrations of cholesterol, apolipoprotein B, and apolipoprotein A I.


RESULTS
238 (15%) of the men were positive for hepatitis B surface antigen, indicating that they were chronic carriers. Plasma concentration of cholesterol was 4.2% (0.11 mmol/l) lower among carriers (that is, positive for hepatitis B surface antigen) than among non-carriers (95% confidence interval 0.6% to 8.0% (0.01 to 0.21 mmol/l), p < 0.05), and apolipoprotein B concentration was 7.0% (0.036 g/l) lower (2.8% to 11.2% (0.014 to 0.058 g/l), p < 0.001). In contrast, no association was observed between plasma concentrations of cholesterol or apolipoprotein and hepatitis B that had been eradicated (that is, patient positive for hepatitis B core antibody but negative for hepatitis B surface antigen).


CONCLUSIONS
Chronic hepatitis B virus infection, which usually starts in early childhood in China, seems to lead not only to a greatly increased risk of death from liver disease but also to a somewhat lower cholesterol concentration in adulthood. This common cause produces an inverse association between cholesterol concentration and risk of death from liver cancer or from other chronic liver diseases.
Chen
Z
Z
Nuffield Department of Clinical Medicine, University of Oxford, Radcliffe Infirmary.
Keech
A
A
Collins
R
R
Slavin
B
B
Chen
J
J
Campbell
T C
TC
Peto
R
R
D000328:Adult; D001053:Apolipoproteins / Q000097:blood; D002353:Carrier State / Q000097:blood; D002681:China / Q000453:epidemiology; D002784:Cholesterol / Q000097:blood*; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D006509:Hepatitis B / Q000097:blood* / Q000453:epidemiology; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population
D001053:Apolipoproteins; D002784:Cholesterol