title: Mortality after chronic hepatitis B virus infection: a linkage study involving 2 million parous women from Taiwan.
abstract: BACKGROUND
  Few studies have evaluated survival rates among women who have chronic hepatitis B virus infection. We investigated the overall and disease-specific mortality rates in a nationwide cohort of women after they were screened for hepatitis B surface antigen (HBsAg) during pregnancy.
  
  
  METHODS
  HBsAg prenatal screening data were available for 2,087,994 women in Taiwan between 1 January 1986 and 31 March 2000 in the National Hepatitis B Vaccination Registry. Their vital status and cause of death were ascertained by computerized linkage with the National Death Certification Registry. Cox proportional hazards models were used to estimate the association between HBsAg status and specific causes of death.
  
  
  RESULTS
  Overall, 14,524 deaths were identified after a mean of 11.43 years of follow-up. The age-adjusted hazard ratio for mortality among HBsAg carriers compared with noncarriers was 1.24 (95% confidence interval [CI], 1.19-1.30), 6.59 (95% CI, 5.70-7.61), and 1.09 (95% CI, 1.04-1.14) for all-cause, liver-specific, and non-liver-related deaths, respectively. In addition to liver-specific causes, a significantly increased risk of mortality from non-Hodgkin lymphoma (P < .001) and gallbladder and extrahepatic bile duct cancer (P = .01) was observed.
  
  
  CONCLUSIONS
  Our study found an excess risk of death due to both liver-specific and non-liver-related causes for HBsAg-positive women in Taiwan. Effective prevention and treatment of hepatitis B virus infection is an important public health priority.
authors.affiliation: Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Chyng-Wen
authors.initials: CW
authors.lastname: Fwu
authors.forename: Yin-Chu
authors.initials: YC
authors.lastname: Chien
authors.forename: Kenrad E
authors.initials: KE
authors.lastname: Nelson
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Kirk
authors.forename: San-Lin
authors.initials: SL
authors.lastname: You
authors.forename: Hsu-Sung
authors.initials: HS
authors.lastname: Kuo
authors.forename: Manning
authors.initials: M
authors.lastname: Feinleib
authors.forename: Chien-Jen
authors.initials: CJ
authors.lastname: Chen
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006508:Hepatitis Antibodies / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000276:immunology; D006515:Hepatitis B virus / Q000302:isolation & purification; D019694:Hepatitis B, Chronic / Q000097:blood / Q000276:immunology / Q000401:mortality*; D006801:Humans; D053208:Kaplan-Meier Estimate; D009035:Mothers; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000097:blood / Q000453:epidemiology; D015995:Prevalence; D016016:Proportional Hazards Models; D018570:Risk Assessment; D013624:Taiwan / Q000453:epidemiology
chemical_list: D006508:Hepatitis Antibodies; D006514:Hepatitis B Surface Antigens