TY - JOUR
T1 - Mortality after chronic hepatitis B virus infection
T2 - A linkage study involving 2 million parous women from Taiwan
AU - Fwu, Chyng Wen
AU - Chien, Yin Chu
AU - Nelson, Kenrad E.
AU - Kirk, Gregory D.
AU - You, San Lin
AU - Kuo, Hsu Sung
AU - Feinleib, Manning
AU - Chen, Chien Jen
PY - 2010/4/1
Y1 - 2010/4/1
N2 - 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 nonliver-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.
AB - 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 nonliver-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.
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U2 - 10.1086/651231
DO - 10.1086/651231
M3 - Article
C2 - 20187745
AN - SCOPUS:77749306165
SN - 0022-1899
VL - 201
SP - 1016
EP - 1023
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 7
ER -