Factors associated with alcohol consumption in hepatitis B carriers: a nationwide study in the Republic of Korea

Hepatitis B prevalence and risk factors among adults living with HIV in South Africa: a clinic-based cohort study

BACKGROUND

People living with HIV (PLHIV) may have concurrent Hepatitis B Virus (HBV) infection, and certain antiretroviral therapies are recommended for HBV-HIV co-infected individuals. Routine screening for Hepatitis B virus may influence management of antiretroviral therapy for PLHIV, but risk factors for co-infection have not been well defined. The objective of this study was to identify risk factors for HBV infection among PLHIV in South Africa.

METHODS

We conducted a cross-sectional analysis of a prospective, clinic-based cohort study of adults seeking HIV testing from 2013-2017 in Umlazi township, South Africa. Patients newly diagnosed with HIV were enrolled and subsequently tested for Hepatitis B surface antigen positive (HBsAg +). We used a Poisson linear regression model to assess which factors, pertaining to sociodemographic status, medical history, clinical symptoms, mental health were associated with HBV.

RESULTS

Among 3,105 PLHIV participants in South Africa, 6% were positive for HBV. Males had a higher HBV prevalence (10.4%) than females (5.2%). Within the HBV-positive group, the mean age was 33.2 years, with 38.3% females and 43.9% having completed high school or higher. About 39.9% reported alcohol use, 24.7% had a smoking history, and 8.3% reported substance use in the past year. Older participants born before 1995, when routine infant HBV vaccination was introduced, were more likely to have HBV. In multivariable analyses, smoking history increased HBV risk in females (aPR = 2.58; 95% CI 1.47-2.52), while alcohol use decreased HBV risk in males (aPR = 0.36; 95% CI 0.19-0.70).

CONCLUSIONS

In a South African cohort, roughly one in 16 PLHIV had HBV co-infection, and this rate was higher in males. The most prominent risk factors for HBV infection in PLHIV were alcohol use, higher income, and smoking history, which may help inform targeted treatment and prevention strategies. Creating HBV-specific screening and prevention strategies for PLHIV may be useful for reducing HBV infections.

Predictors of Hepatitis B screening and vaccination status of young psychoactive substance users in informal settlements in Kampala, Uganda

BACKGROUND

Young psychoactive substance users exhibit high-risk behaviours such as unprotected sexual intercourse, and sharing needles and syringes, which increases their risk of Hepatitis B infection. However, there is limited evidence of screening, and vaccination status of this subgroup. The aim of this study was to establish the predictors of screening and completion of the hepatitis B vaccination schedule.

METHODS

A cross-sectional study using respondent driven sampling was used to enrol respondents from twelve out of fifty-seven informal settlements in Kampala city. Data were collected using an electronic structured questionnaire uploaded on the KoboCollect mobile application, and analysed using Stata version 14. A "modified" Poisson regression analysis was done to determine the predictors of screening while logistic regression was used to determine the predictors of completion of the Hepatitis B vaccination schedule.

RESULTS

About 13.3% (102/768) and 2.7% (21/768) of the respondents had ever screened for Hepatitis B, and completed the Hepatitis B vaccination schedule respectively. Being female (aPR 1.61, 95% CI: 1.11-2.33), earning a monthly income >USD 136 (aPR 1.78, 95% CI: 1.11-2.86); completion of the Hepatitis B vaccination schedule (aPR 1.85, 95% CI: 1.26-2.70); lack of awareness about the recommended Hepatitis B vaccine dose (aPR 0.43, 95% CI: 0.27-0.68); and the belief that the Hepatitis B vaccine is effective in preventing Hepatitis B infection (aPRR 3.67, 95% CI: 2.34-5.73) were associated with "ever screening" for Hepatitis B. Knowledge of the recommended Hepatitis B vaccine dose (aOR 0.06, 95% CI: 0.01-0.35); "ever screening" for hepatitis B (aOR 9.68, 95% CI: 2.17-43.16) and the belief that the hepatitis B vaccine is effective in preventing Hepatitis B infection (aOR 11.8, 95% CI: 1.13-110.14) were associated with completion of the hepatitis B vaccination schedule.

CONCLUSIONS

Our findings indicate a low prevalence of Hepatitis B screening and completion of the Hepatitis B vaccination schedule among young psychoactive substance users in informal settings. It is evident that lack of awareness about Hepatitis B is associated with the low screening and vaccination rates. We recommend creation of awareness of Hepatitis B among young people in urban informal settlements.

Seroprevalence and factors associated with hepatitis B infection among the hill tribe adult population in Thailand: a cross-sectional study

Background

Hepatitis B virus (HBV) infection is one of the greatest public health burdens, particularly for people living with several barriers to access to health care services, such as the hill tribe adult population in Thailand. People aged 25 years and over who are out of the target population for HBV immunization under the national Expanded Program on Immunization (EPI) are at risk of HBV infection. The study aimed to estimate the prevalence and determine the factors associated with HBV infection among hill tribe adults aged 25 years and over living in Chiang Rai Province, Thailand.

Methods

A cross-sectional study design was used to collect information on hill tribe adults aged 25 years and over living in 36 selected hill tribe villages in Chiang Rai Province. All people living in the selected villages who met the criteria were invited to participate in the study. A validated questionnaire and a 5-mL blood specimen were used as research instruments. Hepatitis B surface antigen (HBsAg), antibody to hepatitis B surface (anti-HBs), and antibody to hepatitis B core (anti-HBc) were detected by using the Wondfo Test Kit^@, which has high sensitivity and specificity. Logistic regression was used to detect the associations between variables at the significance level of α = 0.05.

Results

A total of 1491 individuals were recruited into the analysis; 60.8% were females, 81.3% were aged between 30 and 60 years, and 86.0% were married. The majority were illiterate (54.9%), were Buddhist (55.7%), worked in agricultural sectors (87.3%), and had an annual income of less than 50,000 baht per year (72.9%). The overall prevalence of hepatitis B infection was 26.6%; 7.6% were positive for HBsAg, 19.2% were positive for anti-HBs, and 18.9% were positive for anti-HBc. In the multivariate analysis, three variables were found to be associated with hepatitis B infection: those who were in the Yao and Lisu tribes had a 1.64-fold (95% CI = 1.08–2.49) and a 1.93-fold (95% CI = 1.10–3.31) greater chance, respectively, of HBV infection than did those in the Karen tribe; those who were Christian had a 1.41-fold (95% CI = 1.06–1.87) greater chance of HBV infection than did those who were Buddhist; and those who did not use alcohol had a 1.29-fold (95% CI = 1.01–1.65) greater chance of HBV infection than did those who used alcohol.

Conclusions

It is necessary to develop and implement effective public health interventions among hill tribe adult populations who are not part of the EPI-targeted population, particularly Christians, those in the Lisu and Yao tribes, and those who do not use alcohol, to reduce the HBV infection rate, save lives and reduce medical expenses.

Role of alcohol in pathogenesis of hepatitis B virus infection

Hepatitis B virus (HBV) and alcohol abuse often contribute to the development of end-stage liver disease. Alcohol abuse not only causes rapid progression of liver disease in HBV infected patients but also allows HBV to persist chronically. Importantly, the mechanism by which alcohol promotes the progression of HBV-associated liver disease are not completely understood. Potential mechanisms include a suppressed immune response, oxidative stress, endoplasmic reticulum and Golgi apparatus stresses, and increased HBV replication. Certainly, more research is necessary to gain a better understanding of these mechanisms such that treatment(s) to prevent rapid liver disease progression in alcohol-abusing HBV patients could be developed. In this review, we discuss the aforementioned factors for the higher risk of liver diseases in alcohol-induced HBV pathogenies and suggest the areas for future studies in this field.

Understanding Risk Behaviors of Vietnamese Adults with Chronic Hepatitis B in an Urban Setting

Cigarette smoking and alcohol consumption can be considered as risk factors that increase the progression of chronic liver disease. Meanwhile, unprotected sex is one of the main causes of hepatitis B infection. This study aimed to explore drinking, smoking, and risky sexual behaviors among people with chronic hepatitis B virus (HBV) in a Vietnamese urban setting, as well as investigating potential associated factors. A cross-sectional study was performed in October 2018 in Viet-Tiep Hospital, Hai Phong, Vietnam. A total of 298 patients who had been diagnosed with chronic hepatitis B reported their smoking status, alcohol use, and sexual risk behavior in the last 12 months. A multivariate logistic regression model was used to identify the associated factors. It was identified that 82.5% of participants never used alcohol. The Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) positive result among male patients was 7.4% (0% in female patients). In addition, 14.5% of participants were current smokers and the mean number of cigarettes per day was 7.4 (SD = 3.4). It was found that 35.4% of male patients had sex with two or more sex partners. Furthermore, 66.7% and 74.1% of participants used condoms when having sex with casual partners/one-night stands and sex workers, respectively. There was a positive correlation between monthly drinking and currently smoking. White-collar workers were less likely to have multiple sex partners within the last 12 months. Our study highlights the need for integrating counseling sessions and educational programs with treatment services.

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.

Gender-specific relationship between alcohol consumption and injury in the South Korean adults: A nationwide cross-sectional study

Alcohol-related injuries have been concerned worldwide. However, there have been no large cross-sectional epidemiologic studies. The aim of this study was to investigate the association between alcohol and the prevalence of injury according to gender in a representative sample of the South Korean population. This cross-sectional study was based on data obtained in the Korea National Health and Nutrition Examination Survey from 2010 to 2012. In total, 15,249 Korean adults (7128 men and 8112 women) aged 19 years or older were enrolled. Injury was defined as the incidence of an injury or intoxication within the year before completing the survey questionnaire. Univariate and multiple logistic regression analyses were conducted to analyze the relationship between alcohol consumption and the prevalence of injury. Heavy alcohol consumption and high-risk drinking were associated with a higher prevalence of injury in women (adjusted odds ratio [aOR] and corresponding 95% confidence interval [CI]: 2.48 [1.321, 4.656], 1.816 [1.136, 2.929], respectively), and Alcohol Use Disorders Identification Test (AUDIT) scores ≥20 were associated with a higher prevalence of injury in both men and women (aOR and 95% CI: 1.425 [1.004, 2.024] and 3.71 [2.067, 6.66], respectively). According to the AUDIT scores results, women who were injured reported significantly more high-risk drinking behaviors per month compared with those who were not injured. Gender disparities in the relationship between alcohol and the prevalence of injury were found. Indeed, future research using a prospective design should examine the causal relationship between alcohol consumption and the prevalence injury according to gender to confirm that alcohol is a risk factor for injury and to identify the possible mechanisms underlying this phenomenon.

Association between CYP1B1 gene polymorphisms and risk factors and susceptibility to laryngeal cancer

Background

The aim of this study was to investigate the association between polymorphism of the cytochrome P450 1B1 (CYP1B1) gene, a metabolic enzyme gene, and the susceptibility to laryngeal cancer among the Chinese Han population.

Material/Methods

In a case-control study, we investigated polymorphisms in the CYP1B1 gene (rs10012, rs1056827, and rs1056836) with a real-time quantitative polymerase chain reaction (PCR) assay (TaqMan). The study was conducted with 300 Chinese Han patients with laryngeal cancer and 300 healthy Chinese Han subjects in a control group. We also studied the interactions between genetic polymorphism and risk factors such as smoking and alcohol consumption in the pathogenesis of laryngeal cancer.

Results

There were statistically significant differences in the distributions of the rs1056827 and rs1056836 genotypes between the 2 groups. Regarding rs1056827, carriers of the T allele had a significantly higher risk of laryngeal cancer than the G-allele carriers (OR=1.4339, 95% CI: 1.1268–1.8247; P=0.0034). The difference was still statistically significant after adjusting for factors such as age, sex, smoking, and drinking (adjusted OR=1.743, 95% CI: 1.124–3.743, P<0.001). However, regarding rs1056836, the G allele carriers had a significantly lower risk of laryngeal cancer than the C allele carriers (OR=0.5557, 95% CI: 0.3787–0.8154; P=0.0027). The difference was statistically significant even after adjusting for factors such as age, sex, smoking, and drinking (adjusted OR=0.5641, 95% CI: 0.3212–0.8121, P=0.001). Subjects who carry the C-T-C haplotype have a significantly increased incidence of laryngeal cancer. We also found that CYP1B1 rs1056827 polymorphism had synergistic effects with smoking or alcohol consumption regarding the risk of laryngeal cancer.

Conclusions

CYP1B1 gene polymorphism is closely related to the onset of laryngeal cancer. There is a mutually synergistic effect between smoking, alcohol consumption, and CYP1B1 gene polymorphisms regarding laryngeal cancer.