title: Female gender lost protective effect against disease progression in elderly patients with chronic hepatitis B.
abstract: Female gender and younger age are protective factors against disease progression in chronic hepatitis B (CHB). However, it is not clear whether the disease progression still remains slow in elderly females. This study investigated the interaction of female gender and older age on the development of cirrhosis in patients recorded in China Registry of Hepatitis B. A total of 17,809 CHB patients were enrolled in this multi-center cross-sectional study. The prevalence of cirrhosis in female CHB patients increased faster than that in male CHB patients over 50 years old. Multivariate analysis showed that the increase of adjusted ORs for developing cirrhosis in females started to accelerate after 50 years old: 11.19 (95% CI: 5.93-21.11) in women versus 14.75 (95% CI: 8.35-26.07) in men at ages of 50-59 years, 21.67 (95% CI: 11.05-42.47) versus 24.4 (95% CI: 13.00-45.80) at ages 60-69 years, and 18.78 (95% CI: 6.61-53.36) versus 12.09 (95% CI: 4.35-33.61) in those over 70 years. In conclusion, the protective effect of female gender against cirrhosis gradually lost with increasing age, therefore disease progression should be monitored more closely in elderly women with CHB.
authors.affiliation: Liver Research Center, Beijing Friendship Hospital, Capital Medical University; Beijing Key Laboratory of Translational Medicine on Liver Cirrhosis; National Clinical Research Center for Digestive Disease, Beijing, 100050, China.
authors.forename: Hong
authors.initials: H
authors.lastname: You
authors.affiliation: Liver Research Center, Beijing Friendship Hospital, Capital Medical University; Beijing Key Laboratory of Translational Medicine on Liver Cirrhosis; National Clinical Research Center for Digestive Disease, Beijing, 100050, China.
authors.forename: Yuanyuan
authors.initials: Y
authors.lastname: Kong
authors.affiliation: Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
authors.forename: Jinlin
authors.initials: J
authors.lastname: Hou
authors.affiliation: Peking University People's Hospital, Beijing, 100044, China.
authors.forename: Lai
authors.initials: L
authors.lastname: Wei
authors.affiliation: First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, China.
authors.forename: Yuexin
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: First Hospital of Jilin University, Changchun, 130021, China.
authors.forename: Junqi
authors.initials: J
authors.lastname: Niu
authors.affiliation: Tianjin Third Central Hospital, Tianjin Medical University, Tianjin, 300170, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Han
authors.affiliation: Liver Research Center, Beijing Friendship Hospital, Capital Medical University; Beijing Key Laboratory of Translational Medicine on Liver Cirrhosis; National Clinical Research Center for Digestive Disease, Beijing, 100050, China.
authors.forename: Xiaojuan
authors.initials: X
authors.lastname: Ou
authors.affiliation: Shengjing Hospital of China Medical University, Shenyang, 110022, China.
authors.forename: Xiaoguang
authors.initials: X
authors.lastname: Dou
authors.affiliation: Henan Provincial People's Hospital, Zhengzhou, 450003, China.
authors.forename: Jia
authors.initials: J
authors.lastname: Shang
authors.affiliation: West China Hospital of Sichuan University, Chengdu, 610041, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Tang
authors.affiliation: Shanghai Ruijin Hospital, Jiao Tong University School of Medicine, Shanghai, 200025, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Xie
authors.affiliation: Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China.
authors.forename: Huiguo
authors.initials: H
authors.lastname: Ding
authors.affiliation: The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Ren
authors.affiliation: Peking University First Hospital, Beijing, 100034, China.
authors.forename: Xiaoyuan
authors.initials: X
authors.lastname: Xu
authors.affiliation: Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Xie
authors.affiliation: Peking Union Medical College Hospital, Beijing, 100730, China.
authors.forename: Xiaoqing
authors.initials: X
authors.lastname: Liu
authors.affiliation: Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, China.
authors.forename: Youqing
authors.initials: Y
authors.lastname: Xu
authors.affiliation: The Third People's Hospital of Taiyuan, Taiyuan, 030012, China.
authors.forename: Yujie
authors.initials: Y
authors.lastname: Li
authors.affiliation: Peking University Health Science Center, Beijing, 100191, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Biostatistics &Bioinformatics, Duke University School of Medicine, Durham, 27710, USA.
authors.forename: Shein-Chung
authors.initials: SC
authors.lastname: Chow
authors.affiliation: Peking University Health Science Center, Beijing, 100191, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Zhuang
authors.affiliation: Liver Research Center, Beijing Friendship Hospital, Capital Medical University; Beijing Key Laboratory of Translational Medicine on Liver Cirrhosis; National Clinical Research Center for Digestive Disease, Beijing, 100050, China.
authors.forename: Jidong
authors.initials: J
authors.lastname: Jia
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging / Q000276:immunology*; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D006515:Hepatitis B virus / Q000276:immunology / Q000472:pathogenicity; D019694:Hepatitis B, Chronic / Q000150:complications / Q000453:epidemiology / Q000276:immunology* / Q000821:virology; D006801:Humans; D007113:Immunity, Innate; D008103:Liver Cirrhosis / Q000453:epidemiology / Q000209:etiology / Q000276:immunology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012042:Registries; D012737:Sex Factors