|Title:||EXCESS MORTALITY OF HEPATOCELLULAR CARCINOMA AND MORBIDITY OF LIVER CIRRHOSIS AND HEPATITIS IN HCV- ENDEMIC AREAS IN AN HBV-ENDEMIC COUNTRY: GEOGRAPHIC VARIATIONS AMONG 502 VILLAGES IN SOUTHERN TAIWAN||Authors:||KEE, KWONG-MING
CHEN, TONY, HSIU-HSI
|Keywords:||hepatitis B virus;hepatitis C virus;hepatocellular carcinoma;thrombocytopenia;transaminases||Issue Date:||2007||Journal Volume:||v.22||Journal Issue:||n.1||Start page/Pages:||92-98||Source:||JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY||Abstract:||
The aim of this study was to investigate excess mortality for hepatocellular carcinoma (HCC) and prevalence of hepatitis and liver cirrhosis (LC) in hepatitis C virus (HCV )-endemic areas in Taiwan, which is a hepatitis B virus ( HBV )-endemic country. Tainan County, located in southern Taiwan , consists of 533 villages in 31 townships. A total of 56 702 subjects >= 40 years old (mean age, 60.9 +/- 11.8 years) were enrolled from 502 of the 533 villages between April and November 2004 (n >= 20/village). Serum blood HBV surface antigen (HBsAg), antibody to HCV (anti-HCV) and alanine transaminase (ALT) levels and platelet counts were measured. Township-specific mortality for liver cancer (ICD = 155) for both sexes between 1992 and 2001 were obtained from official publications. The prevalence of anti-HCV in Tainan County was 10.2% (township range, 2.6-30.9%; village range, 0-90.5%). The prevalence of HBsAg was 10.9% (township range, 5.5-17.2%; village range, 0-30.8%). The prevalence of hypertransaminemia (serum ALT > 40 IU/L) was 12.8%. At township levels, prevalence of anti-HCV (r(2) = 0.92, P < 0. 001), HBsAg and anti-HCV (multiple r(2) = 0.94) were correlated with hypertransaminemia prevalence by single and multiple linear analysis, respectively. At village levels, prevalence of anti-HCV (r(2) = 0.52, P < 0.001), HBsAg and anti-HCV (multiple r(2) = 0.53) were each correlated with prevalence of hypertransaminemia, respectively. The prevalence of thrombocytopenia (< 150 000 platelets/mu L) was 5.5%, and adopted as a surrogate prevalence for LC. At township levels, prevalence of anti-HCV (r(2) = 0.58) was the only factor correlated by multivariate analysis with prevalence of thrombocytopenia. At village levels, prevalence of anti-HCV and female-to-male ratio (multiple r( 2) = 0.43) were each independently associated with prevalence of thrombocytopenia. At township levels, HBsAg prevalence (r(2) = 0.42) was more correlated with HCC mortality than anti-HCV prevalence (r(2) = 0.28) for male subjects, while anti-HCV prevalence (r(2) = 0.45) was more correlated with HCC mortality than HBsAg prevalence (r(2) = 0.14) for female subjects. Prevalence of HBV and HCV infection were associated by multivariate analysis with both male (multiple r(2) = 0.62) and female (multiple r(2) = 0. 53) HCC mortality. Prevalence of anti-HCV showed significant correlations with prevalence of hypertransaminemia, thrombocytopenia and liver cancer mortality. The findings indicate excessive mortality due to HCC, and LC and hepatitis prevalence in HCV-endemic areas in Taiwan, an HBV- endemic country.
|Appears in Collections:||流行病學與預防醫學研究所|
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