Chronic hepatitis B virus infection and risk of dyslipidaemia: A cohort study

Hepatitis B virus (HBV) infection has been associated with a decreased prevalence of dyslipidaemia in cross-sectional studies, but cohort studies are limited. We investigated the longitudinal effects of chronic HBV infection on the development of dyslipidaemia. We performed a cohort study of 62 287 non-cirrhotic adult men and women free of dyslipidaemia who underwent serologic testing for hepatitis B surface antigen (HBsAg) and were followed annually or biennially for an average of 4.46 years. A parametric proportional hazard model was used to estimate the adjusted hazard ratio with 95% confidence interval (CI) for incident dyslipidaemia according to HBsAg seropositivity status. We identified 12 331 incident cases of hypercholesterolaemia during 278 004.4 person-years of follow-up (incident rate 44.4 per 1000 person-years). In models adjusted for age, sex, body mass index, year of screening exam, smoking status, alcohol intake, regular exercise and education level, the adjusted hazard ratios (95% CIs) for incident hypercholesterolaemia, high LDL cholesterolaemia; hypertriglyceridaemia, high non-HDL cholesterolaemia and low HDL cholesterolaemia comparing HBsAg-positive to HBsAg-negative participants was 0.71 (0.64-0.79), 0.83 (0.78-0.89), 0.61 (0.54-0.70), 0.69 (0.63-0.75) and 1.10 (0.98-1.24), respectively. An inverse association between HBsAg positivity and incident high apolipoprotein B were also identified, with a corresponding a hazard ratio of 0.63 (0.55-0.72). In a large cohort of apparently healthy Korean adults, HBsAg seropositivity was associated with lower risk of development of dyslipidaemia, suggesting a role of HBV infection in lipid metabolism.