title: Arsenic exposure and the seroprevalence of total hepatitis A antibodies in the US population: NHANES, 2003-2012.
abstract: We evaluated the association between urinary arsenic and the seroprevalence of total hepatitis A antibodies (total anti-HAV: IgG and IgM) in 11 092 participants aged ⩾6 years using information collected in the US National Health and Nutrition Examination Survey (2003-2012). Multivariate logistic regression models evaluated associations between total anti-HAV and total urinary arsenic defined as the sum of arsenite, arsenate, monomethylarsonate and dimethylarsinate (TUA1). Effect modification by self-reported HAV immunization status was evaluated. Total anti-HAV seroprevalence was 35·1% [95% confidence interval (CI) 33·3-36·9]. Seropositive status was associated with higher arsenic levels and this association was modified by immunization status (P = 0·03). For participants that received ⩾2 vaccine doses or did not know if they had received any doses, a positive dose-response association was observed between increasing TUA1 and odds of total anti-HAV [odds ratio (OR) 1·42, 95% CI 1·11-1·81; and OR 1·75, 95% CI 1·22-2·52], respectively. A positive but not statistically significant association was observed in those who received <2 doses (OR 1·46, 95% CI 0·83-2·59) or no dose (OR 1·12, 95% CI 0·98-1·30). Our analysis indicates that prevalent arsenic exposure was associated with positive total anti-HAV seroprevalence. Further studies are needed to determine if arsenic increases the risk for incident hepatitis A infection or HAV seroconversion.
authors.affiliation: School of Biological and Population Health Sciences,College of Public Health and Human Sciences,Oregon State University,Corvallis,OR,USA.
authors.forename: A
authors.initials: A
authors.lastname: Cardenas
authors.affiliation: School of Biological and Population Health Sciences,College of Public Health and Human Sciences,Oregon State University,Corvallis,OR,USA.
authors.forename: E
authors.initials: E
authors.lastname: Smit
authors.affiliation: School of Biological and Population Health Sciences,College of Public Health and Human Sciences,Oregon State University,Corvallis,OR,USA.
authors.forename: J W
authors.initials: JW
authors.lastname: Bethel
authors.affiliation: School of Biological and Population Health Sciences,College of Public Health and Human Sciences,Oregon State University,Corvallis,OR,USA.
authors.forename: E A
authors.initials: EA
authors.lastname: Houseman
authors.affiliation: School of Biological and Population Health Sciences,College of Public Health and Human Sciences,Oregon State University,Corvallis,OR,USA.
authors.forename: M L
authors.initials: ML
authors.lastname: Kile
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001151:Arsenic / Q000652:urine*; D002648:Child; D003430:Cross-Sectional Studies; D004785:Environmental Pollutants / Q000652:urine*; D005260:Female; D035922:Hepatitis A Antibodies / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D016036:Seroepidemiologic Studies; D014481:United States; D055815:Young Adult
chemical_list: D004785:Environmental Pollutants; D035922:Hepatitis A Antibodies; D001151:Arsenic
keywords: Antibody responses; NHANES; arsenic; hepatitis A; hepatitis immunization; immunotoxicity