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Prolonged infection with hepatitis B virus and association between low blood cholesterol concentration and liver
1Nuffield Department of Clinical Medicine, University of Oxford, Radcliffe Infirmary.
Insights
Chronic hepatitis B virus infection is linked to lower cholesterol levels in adults. This finding suggests an inverse relationship between cholesterol concentration and the risk of liver disease mortality.
Area of Science:
- Hepatology
- Epidemiology
- Biochemistry
Background:
- Hepatitis B virus (HBV) infection is a significant global health concern, particularly in regions like China.
- Chronic HBV infection is a major risk factor for liver cancer and other chronic liver diseases.
- The relationship between chronic HBV infection and lipid metabolism, specifically cholesterol levels, remains an area of investigation.
Purpose of the Study:
- To investigate the association between chronic hepatitis B virus (HBV) infection and blood cholesterol concentration.
- To determine if prolonged HBV infection influences plasma levels of cholesterol and apolipoproteins.
Main Methods:
- A cross-sectional study was conducted in 81 villages in rural China.
- 1556 healthy men aged 35-64 years were randomly selected.
- Hepatitis B virus carrier status, plasma cholesterol, apolipoprotein B, and apolipoprotein A I concentrations were measured.
Main Results:
- 15% of participants were chronic HBV carriers (positive for hepatitis B surface antigen).
- Chronic HBV carriers exhibited significantly lower plasma cholesterol (4.2% lower) and apolipoprotein B concentrations compared to non-carriers.
- No association was found between cholesterol levels and eradicated hepatitis B infection.
Conclusions:
- Chronic hepatitis B virus infection in adulthood is associated with lower cholesterol concentrations.
- This association may contribute to the observed inverse relationship between cholesterol and mortality from liver disease.
- The findings highlight a potential dual impact of chronic HBV infection on liver health and metabolic parameters.
Objective:
To determine whether prolonged infection with hepatitis B virus is associated with a lower blood cholesterol concentration.
Design:
Cross sectional study.
Setting:
81 villages in rural China with a high prevalence of chronic infection with hepatitis B virus.
Subjects:
1556 apparently healthy men aged 35-64 years, randomly selected.
Main Outcome Measures:
Hepatitis B virus carrier state; plasma concentrations of cholesterol, apolipoprotein B, and apolipoprotein A I.
Results:
238 (15%) of the men were positive for hepatitis B surface antigen, indicating that they were chronic carriers. Plasma concentration of cholesterol was 4.2% (0.11 mmol/l) lower among carriers (that is, positive for hepatitis B surface antigen) than among non-carriers (95% confidence interval 0.6% to 8.0% (0.01 to 0.21 mmol/l), p < 0.05), and apolipoprotein B concentration was 7.0% (0.036 g/l) lower (2.8% to 11.2% (0.014 to 0.058 g/l), p < 0.001). In contrast, no association was observed between plasma concentrations of cholesterol or apolipoprotein and hepatitis B that had been eradicated (that is, patient positive for hepatitis B core antibody but negative for hepatitis B surface antigen).
Conclusions:
Chronic hepatitis B virus infection, which usually starts in early childhood in China, seems to lead not only to a greatly increased risk of death from liver disease but also to a somewhat lower cholesterol concentration in adulthood. This common cause produces an inverse association between cholesterol concentration and risk of death from liver cancer or from other chronic liver diseases.