title: Combined effects of chronic hepatitis virus infections and substance-use habits on chronic liver diseases in Taiwanese aborigines.
abstract: OBJECTIVE
  Chronic liver disease (CLD) is a major cause of death in Taiwanese aborigines. The roles of substance-use habits and hepatitis B virus (HBV) and hepatitis C virus (HCV) infections in the development of CLD are not well understood in this indigenous population.
  
  
  METHODS
  A hospital-based, case-control study of 79 consecutive CLD patients and 107 non-CLD controls was performed. Serostatus of hepatitis B surface antigen (HBsAg) and antibodies against hepatitis C virus (anti-HCV) were determined in all subjects. Each subject completed an epidemiologic questionnaire about the risk factors of CLD.
  
  
  RESULTS
  Atayal ethnicity, alcohol drinking, cigarette smoking, betel quid chewing, seropositivity of HBsAg and anti-HCV antibodies were associated with a significantly elevated CLD risk. In the combinatory analyses of HBsAg serostatus and substance-use habits, HBsAg-positive substance users had the highest CLD risk, followed by HBsAg-positive non-users, HBsAg-negative users, and HBsAg-negative non-users. Similarly, anti-HCV-positive alcohol drinkers and betel quid chewers had greater CLD risks than other groups. The multivariate-adjusted odds ratios (ORs) for males, Atayal ethnicity and seropositivity of HBsAg and anti-HCV were significantly elevated. There was a biologic gradient in the risk of developing CLD associated with the number of substance-use habits. The multivariate-adjusted ORs were 4.7 (95% confidence interval [CI], 1.3-16.8) and 7.9 (95% CI, 2.1-30.4) for subjects with 1-2 and 3 habits, respectively, compared to subjects with no habit.
  
  
  CONCLUSIONS
  Our data suggest that chronic HBV and HCV infections, alcohol drinking, cigarette smoking, and betel quid chewing play important roles in the development of CLD in Taiwanese aborigines.
authors.affiliation: Center of Hepatology, Tzu Chi General Hospital, Hualien, Taiwan.
authors.forename: Hans-Hsienhong
authors.initials: HH
authors.lastname: Lin
authors.forename: Li-Yu
authors.initials: LY
authors.lastname: Wang
authors.forename: Cheng-Kuang
authors.initials: CK
authors.lastname: Shaw
authors.forename: Mu-Liang
authors.initials: ML
authors.lastname: Cheng
authors.forename: Wen-Kuan
authors.initials: WK
authors.lastname: Chung
authors.forename: Hsin-Jung
authors.initials: HJ
authors.lastname: Chiang
authors.forename: Teng-Yi
authors.initials: TY
authors.lastname: Lin
authors.forename: Chien-Jen
authors.initials: CJ
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000150:complications*; D001114:Areca / Q000009:adverse effects; D016022:Case-Control Studies; D002908:Chronic Disease; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications*; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D008107:Liver Diseases / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D044469:Racial Groups; D013624:Taiwan / Q000208:ethnology; D014029:Tobacco Use Disorder / Q000150:complications*