Chronic hepatitis B virus infection and total and cause-specific mortality: a prospective cohort study of 0.5 million people. Issue 4 (9th April 2019)

• Record Type: Journal Article
• Authors: Si, Jiahui; Yu, Canqing; Guo, Yu; Bian, Zheng; Meng, Ruogu; Yang, Ling; Chen, Yiping; Jin, Jianrong; Liu, Jingchao; Guo, Ziyan; Chen, Junshi; Chen, Zhengming; Lv, Jun; Li, Liming
• Other Names: author non-byline.; Collins Rory author non-byline.; Peto Richard author non-byline.; Avery Daniel author non-byline.; Boxall Ruth author non-byline.; Bennett Derrick author non-byline.; Chang Yumei author non-byline.; Clarke Robert author non-byline.; Du Huaidong author non-byline.; Gilbert Simon author non-byline.; Hacker Alex author non-byline.; Holmes Michael author non-byline.; Iona Andri author non-byline.; Kartsonaki Christiana author non-byline.; Kerosi Rene author non-byline.; Kong Ling author non-byline.; Kurmi Om author non-byline.; Lancaster Garry author non-byline.; Lewington Sarah author non-byline.; Lin Kuang author non-byline.; Mcdonnell John author non-byline.; Mei Winnie author non-byline.; Millwood Iona author non-byline.; Nie Qunhua author non-byline.; Radhakrishnan Jayakrishnan author non-byline.; Rafiq Sajjad author non-byline.; Ryder Paul author non-byline.; Sansome Sam author non-byline.; Schmidt Dan author non-byline.; Sherliker Paul author non-byline.; Sohoni Rajani author non-byline.; Turnbull Iain author non-byline.; Walters Robin author non-byline.; Wang Jenny author non-byline.; Wang Lin author non-byline.; Yang Xiaoming author non-byline.; Chen Ge author non-byline.; Hou Can author non-byline.; Pei Pei author non-byline.; Qu Shuzhen author non-byline.; Tan Yunlong author non-byline.; Pang Zengchang author non-byline.; Gao Ruqin author non-byline.; Wang Shaojie author non-byline.; Liu Yongmei author non-byline.; Du Ranran author non-byline.; Zang Yajing author non-byline.; Cheng Liang author non-byline.; Tian Xiaocao author non-byline.; Zhang Hua author non-byline.; Lv Silu author non-byline.; Wang Junzheng author non-byline.; Hou Wei author non-byline.; Yin Jiyuan author non-byline.; Jiang Ge author non-byline.; Zhou Xue author non-byline.; Yang Liqiu author non-byline.; He Hui author non-byline.; Yu Bo author non-byline.; Li Yanjie author non-byline.; Mu Huaiyi author non-byline.; Xu Qinai author non-byline.; Dou Meiling author non-byline.; Ren Jiaojiao author non-byline.; Wang Shanqing author non-byline.; Hu Ximin author non-byline.; Wang Hongmei author non-byline.; Chen Jinyan author non-byline.; Fu Yan author non-byline.; Fu Zhenwang author non-byline.; Wang Xiaohuan author non-byline.; Weng Min author non-byline.; Zheng Xiangyang author non-byline.; Li Yilei author non-byline.; Li Huimei author non-byline.; Wang Yanjun author non-byline.; Wu Ming author non-byline.; Zhou Jinyi author non-byline.; Tao Ran author non-byline.; Yang Jie author non-byline.; Ni Chuanming author non-byline.; Zhang Jun author non-byline.; Hu Yihe author non-byline.; Lu Yan author non-byline.; Ma Liangcai author non-byline.; Tang Aiyu author non-byline.; Zhang Shuo author non-byline.; Tang Zhenzhu author non-byline.; Chen Naying author non-byline.; Huang Ying author non-byline.; Li Mingqiang author non-byline.; Meng Jinhuai author non-byline.; Pan Rong author non-byline.; Jiang Qilian author non-byline.; Zhang Weiyuan author non-byline.; Liu Yun author non-byline.; Wei Liuping author non-byline.; Zhou Liyuan author non-byline.; Chen Ningyu author non-byline.; Guan Hairong author non-byline.; Wu Xianping author non-byline.; Zhang Ningmei author non-byline.; Chen Xiaofang author non-byline.; Tang Xuefeng author non-byline.; Luo Guojin author non-byline.; Li Jianguo author non-byline.; Zhong Xunfu author non-byline.; Liu Jiaqiu author non-byline.; Sun Qiang author non-byline.; Ge Pengfei author non-byline.; Ren Xiaolan author non-byline.; Dong Caixia author non-byline.; Zhang Hui author non-byline.; Mao Enke author non-byline.; Wang Xiaoping author non-byline.; Wang Tao author non-byline.; Zhang Xi author non-byline.; Zhang Ding author non-byline.; Zhou Gang author non-byline.; Feng Shixian author non-byline.; Chang Liang author non-byline.; Fan Lei author non-byline.; Gao Yulian author non-byline.; He Tianyou author non-byline.; Sun Huarong author non-byline.; He Pan author non-byline.; Hu Chen author non-byline.; Lv Qiannan author non-byline.; Zhang Xukui author non-byline.; Yu Min author non-byline.; Hu Ruying author non-byline.; Wang Hao author non-byline.; Qian Yijian author non-byline.; Wang Chunmei author non-byline.; Xie Kaixue author non-byline.; Chen Lingli author non-byline.; Zhang Yidan author non-byline.; Pan Dongxia author non-byline.; Huang Yuelong author non-byline.; Chen Biyun author non-byline.; Yin Li author non-byline.; Jin Donghui author non-byline.; Liu Huilin author non-byline.; Fu Zhongxi author non-byline.; Xu Qiaohua author non-byline.; Xu Xin author non-byline.; Zhang Hao author non-byline.; Xiong Youping author non-byline.; Long Huajun author non-byline.; Li Xianzhi author non-byline.; Zhang Libo author non-byline.; Qiu Zhe author non-byline.;
• Is Part Of: BMJ open. Volume 9:Issue 4(2019)
• Publication Date: 2019-04-09
• Subjects: chronic hepatitis B virus infection -- mortality -- stroke -- ischaemic heart disease -- prospective cohort study; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2018-027696
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objectives: Chronic hepatitis B virus (HBV) infection is associated with a higher risk of liver diseases. Substantial uncertainty remains, however, about the associations of HBV infection with mortality from extrahepatic causes, especially from subtypes of cardiovascular diseases. We prospectively examined the association of chronic HBV infection with total and cause-specific mortality. Design: Population-based prospective cohort study. Setting: China Kadoorie Biobank in which participants from 10 geographically diverse areas across China were enrolled between 2004 and 2008. Participants: 475 801 participants 30–79 years of age without reporting major chronic diseases at baseline were enrolled. Hepatitis B surface antigen (HBsAg) was tested using an on-site rapid test strip at baseline. Primary and secondary outcome measures: Total and cause-specific mortality. Results: A total of 35 822 deaths were recorded during ~10 years of follow-up. In multivariable-adjusted analyses, compared with HBsAg-negative participants, HBsAg-positive participants had an increased risk of total mortality (HR=2.01, 95% CI: 1.91 to 2.12), which was higher in men (HR=2.16, 95% CI: 2.01 to 2.31) than in women (HR=1.74, 95% CI: 1.60 to 1.90). Presence of HBsAg was associated with increased mortality from liver cancer (1339 deaths, HR=13.95, 95% CI: 12.46 to 15.62), infections (410 deaths, HR=10.30, 95% CI: 8.21 to 12.94), digestive diseases (688 deaths, HR=6.83, 95% CI: 5.49 to 8.50), intracerebral haemorrhage (4077 deaths, HR=1.38, 95% CI: 1.14 to 1.68) and ischaemic heart diseases (4624 deaths, HR=1.31, 95% CI: 1.09 to 1.58). The positive association between HBsAg status and risk of death was stronger in participants younger than 50 years, smokers, physically active or non-hypertensive participants. Conclusions: Among Chinese adults, chronic HBV infection was associated with increased mortality from a range of hepatic and extrahepatic diseases.