BACKGROUND: Conflicting results have been reported on the association of chronic hepatitis B infection with risks of atherosclerotic diseases previously. The present study aimed to clarify the association between HBsAg seropositivity and atherosclerosis-related/cardiovascular mortality prospectively in Taiwan, one of the most endemic areas for hepatitis B infection in the world.
METHODS AND RESULTS: After excluding subjects with HCV infection, we followed up a total of 22,472 subjects aged 30-65 years, consisting of 18,541 HBsAg seronegatives and 3931 seropositives, for 17 years for mortality. Cox proportional hazard models were used to estimate the hazard ratios of mortality after adjustment for traditional risk factors, glomerular filtration rates and the competing risk of liver mortality. In multivariate Cox regression analysis, taking into account liver mortality as a competing risk, the fully adjusted hazard ratios (95% CIs) of mortality from ischemic heart disease, cerebrovascular disease, atherosclerotic disease and all cardiovascular disease were 0.98 (0.82-1.17, P=0.28), 0.86 (0.79-1.05, P=0.25), 0.84 (0.72-1.06, P=0.27), and 0.96 (0.82-1.13, P=0.21) respectively for HBsAg seropositives compared with HBsAg seronegatives.
CONCLUSION: HBsAg seropositivity was not associated with increased mortality risks of atherosclerosis-related/cardiovascular diseases during 17-year follow-up. HBsAg seropositivity might not be a significant predictor for atherosclerosis-related/cardiovascular deaths.