Increased incidence of gastroesophageal reflux disease in patients with chronic hepatitis B virus infection
Journal
Hepatology International
Journal Volume
4
Journal Issue
3
Pages
585-593
Date Issued
2010
Author(s)
Hsu C.-S.
Wang C.-C.
Wang P.-C.
Lin H.H.
Chen C.-H.
Su W.-C.
Lai M.-Y.
Abstract
Background: Although chronic liver disease is associated with gastroesophageal reflux disease (GERD), the impact of chronic hepatitis B virus (HBV) infection on this association remains unclear. We thus aimed to evaluate the relationship between chronic HBV infection and GERD. Methods: In this prospective population-based study, 1,001 adult subjects who underwent an upper gastrointestinal endoscopic examination in a health check-up and completed a gastroesophageal reflux questionnaire were consecutively enrolled. Endoscopic findings were classified according to the Los Angeles classification. Hepatitis B surface antigen was used as a marker of HBV infection. Univariate and multivariate approaches were used to evaluate the effects of chronic HBV infection on GERD. Results: Chronic HBV infection was associated with heartburn sensation [odds ratio (OR) 1.27, 95% confidence interval 1.01-1.61, P = 0.037], and erosive esophagitis (adjusted OR 1.75, 1.03-2.97, P = 0.037). Although male gender is a risk factor of erosive esophagitis, further analyses stratified by gender and aspartate aminotransferase to platelet ratio index (APRI) showed that chronic HBV infection was associated with erosive esophagitis in female subjects (adjusted OR 2.70, 1.14-6.39, P = 0.024) and those with APRI of more than 0.3 (adjusted OR 3.94, 1.73-8.96, P = 0.001). Moreover, higher serum aspartate aminotransferase (AST) and triglyceride (TG) levels were risk factors of erosive esophagitis in patients with chronic HBV infection. Conclusions: Our findings indicate a close association between chronic HBV infection and GERD, especially in female subjects and those with higher APRI levels. Moreover, HBV carriers with higher AST or TG levels have higher incidence of erosive esophagitis. The interactions between chronic HBV infection and GERD need further studies. ? 2010 Asian Pacific Association for the Study of the Liver.
SDGs
Other Subjects
aspartate aminotransferase; hepatitis B surface antigen; triacylglycerol; adult; article; aspartate aminotransferase blood level; controlled study; disease association; disease classification; female; gastroesophageal reflux; gastrointestinal endoscopy; heartburn; hepatitis B; human; major clinical study; male; medical examination; multivariate analysis; priority journal; prospective study; questionnaire; reflux esophagitis; risk factor; sex difference; thrombocyte count; triacylglycerol blood level; univariate analysis; virus carrier
Publisher
Springer New York LLC
Type
journal article