HBV genotype C is independently associated with cirrhosis in community-based population.
OBJECTIVE
To determine the association of hepatitis B virus (HBV) genotypes with probable cirrhosis and fatty liver in community-based populations.


METHODS
A multi-stage cluster probability sampling method was applied to recruit 10 167 subjects aged between 6 and 72 years from our epidemiological bases in Eastern China. After excluding the subjects co-infected with hepatitis C or hepatitis D viruses, the hepatitis B surface antigen (HBsAg)-positive subjects were examined for HBV genotype, serum viral load, alanine aminotransferase (ALT), hepatitis B e antigen (HBeAg) status, and ultrasonographic changes. Logistic regression models were used to determine the factors associated with probable cirrhosis and fatty liver.


RESULTS
Of 634 HBsAg-positive subjects with HBV genotype determined, 82 had probable cirrhosis (ultrasonographic score > or = 5), 42 had ultrasonographic fatty liver. Probable cirrhosis was only found in the HBeAg-negative subjects, and more frequently found in the subjects with genotype C than in those with genotype B (14.8% vs 8.0%, P = 0.018). In HBeAg-negative subjects, high viral load was frequently associated with abnormal ALT level, while ALT abnormality was more frequent in those with probable cirrhosis than those without (19.5% vs 7.8%, P = 0.001). Univariate analysis showed that age, sex, HBV genotypes, and viral load were not significantly associated with ultrasonographic fatty liver, whereas ALT abnormality was significantly related to ultrasonographic fatty liver (OR = 4.54, 95% CI: 2.11-9.75, P < 0.001). Multivariate analysis demonstrated that HBV genotype C, age (> or = 45 years), male sex, and ALT abnormality were independently associated with probable cirrhosis (AOR = 2.30, 95% CI: 1.26-4.19; AOR = 1.81, 95% CI: 1.10-2.99; AOR = 1.74, 95% CI: 1.03-2.95; AOR = 2.98, 95% CI: 1.48-5.99, respectively).


CONCLUSIONS
A crude prevalence of probable cirrhosis is 12.9% in the community-based HBV-infected subjects. HBV genotype C is independently associated with probable cirrhosis in the HBeAg-negative subjects.
Yin
Jian-Hua
JH
Department of Epidemiology, Second Military Medical University, 800 Xiangyin Rd., Shanghai 200433, China.
Zhao
Jun
J
Zhang
Hong-Wei
HW
Xie
Jia-Xin
JX
Li
Wei-Ping
WP
Xu
Guo-Zhang
GZ
Shen
Jie
J
Dong
Hong-Jun
HJ
Zhang
Jun
J
Wang
Lin
L
Han
Jian-Kang
JK
Wang
Hong-Yang
HY
Cao
Guang-Wen
GW
D000293:Adolescent; D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D002648:Child; D002681:China; D016000:Cluster Analysis; D055812:Community-Based Participatory Research; D005234:Fatty Liver / Q000453:epidemiology / Q000208:ethnology / Q000821:virology; D005260:Female; D005838:Genotype; D006513:Hepatitis B e Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000235:genetics*; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging; D008103:Liver Cirrhosis / Q000453:epidemiology* / Q000208:ethnology / Q000821:virology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012189:Retrospective Studies; D014463:Ultrasonography; D019562:Viral Load / Q000235:genetics; D055815:Young Adult
D006513:Hepatitis B e Antigens; D000410:Alanine Transaminase