Gender differences in chronic HBsAg carriers in Italy: Evidence for the independent role of male sex in severity of liver disease
Gender differences in chronic HBsAg carriers in Italy: Evidence for the independent role of male sex in severity of liver disease
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DOI：
10.1002/jmv.24243
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发表时间：
2015-11-01
影响因子：
12.7
通讯作者：
Almasio, Piero Luigi
中科院分区：
文献类型：
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作者：
Stroffolini, Tommaso;Esvan, Rozenn;Almasio, Piero Luigi
研究表明，性激素对肝纤维化进展和肝细胞癌的发展具有相反的作用。2001年和2007年连续转诊到意大利医院的2,762名慢性HBsAg携带者的性别差异进行了评估，特别关注性别对肝病严重程度的作用。整体性别比率（男性/女性）为2.6。女性更有可能出生在国外和新的诊断病例，但不太可能合并感染艾滋病毒。与其他肝炎病毒合并感染无性别差异。性别比随肝病严重程度的增加而线性增加，ALT正常组为1.3，慢性肝炎组为2.8，肝硬化组为3.6，肝细胞癌组为6.8。对年龄、酒精摄入、HDV感染、HCV感染和BMI的混杂效应进行多元logistic回归分析调整后显示，男性是更严重肝病（O.R. 1.7; C.I. 95%=1.3-2.1）。HBV-DNA水平与慢性HBV感染的结局无关。尽管一些与肝病相关的潜在风险因素，如HBV基因型或突变，由于缺乏可用性而未得到控制，但观察到的慢性HBV感染结局的性别差异可能支持HBV感染可被视为性传播应答病毒的生物学观察结果。医学病毒学杂志87：1899-1903，2015. (c)2015 Wiley Periodicals，Inc.
It has been shown that sexual hormones have an opposite effect on hepatic fibrosis progression and hepatocellular carcinoma development. Sex differences among 2,762 chronic HBsAg carriers consecutively referring Italian hospitals in 2001 and in 2007 have been evaluated, particularly focusing on the role of gender on severity of liver disease. The overall sex ratio (males/females) was 2.6. Females were more likely born abroad and new diagnosis cases; but less likely HIV coinfected. No sex difference was observed regarding coinfection with other hepatitis viruses. The sex ratio linearly increased with increasing severity of liver disease, being 1.3 in normal ALT, 2.8 in chronic hepatitis, 3.6 in liver cirrhosis, and 6.8 in hepatocellular carcinoma. Adjustment by multiple logistic regression analysis for the confounding effect of age, alcohol intake, HDV infection, HCV infection, and BMI shows that male gender is an independent predictor of the likelihood of more severe liver disease (O.R. 1.7; C.I. 95%=1.3-2.1). HBV-DNA levels resulted not associated with the outcome of chronic HBV infection. Despite some potential risk factors associated with liver disease, such as HBV genotype or mutations, not having been controlled for due to lack of availability, the observed sex disparity in the outcome of chronic HBV infection may support biological obervation that HBV infection could be considered a sex hormone-responsive virus. J. Med. Virol. 87:1899-1903, 2015. (c) 2015 Wiley Periodicals, Inc.