Abstract

There have been reports of hepatitis B outbreaks amongst diabetics in long-term care facilities, suggesting that risk of hepatitis B virus (HBV) infection is higher in this population. However, the magnitude of the risk and the incidence of HBV infection amongst the general diabetic population in China remains unknown. Data from a cohort study conducted in Mianyang City, Sichuan Province, China, were retrospectively analyzed in order to address this question. Demographic information was collected using a custom-designed questionnaire, and blood samples were tested for HBV using ELISA. We used multivariate logistic regression to explore the relationship between HBV infection and diabetes, while adjusting for age, sex, region, medical insurance, exposure history, and HBV vaccination. During 2013–2014, a total of 189766 adults were surveyed, of which 7382 were newly infected with HBV, corresponding to an incidence of 3.89%. In this study population, there were 4982 diabetic patients and 182710 non-diabetic individuals. Amongst those with diabetes, 265 (5.32%) were newly infected with HBV. In contrast, 7038 (3.85%) in the non-diabetic population were newly infected with HBV. The relative risk (RR) of HBV infection was 43% higher amongst those diagnosed with diabetes than amongst those not diagnosed (RR 1.43, 95% confidence interval (CI) 1.26–1.63). These results suggest that the risk of HBV infection is higher amongst individuals diagnosed with diabetes mellitus in Mianyang City, Sichuan Province, China. Hepatitis B vaccination and continuous infection control practices may help to reduce HBV infection in diabetic patients, and should be considered for diabetes management.

Highlights

  • Hepatitis B virus (HBV) is a serious and prevalent health problem: an estimated 257 million people live with HBV infection worldwide [1]

  • HBV infection is associated with substantial health risks, since approximately 5% of adults with acute or asymptomatic HBV infection become chronically infected, and individuals infected with this virus are at increased risk of developing hepatic decompensation, cirrhosis, and hepatocellular carcinoma [4,5]

  • After adjusting for several potential confounding factors, including age, sex, region, medical insurance, history of exposure to HBV infection, and history of HBV vaccination, we identified having diabetes as positively associated with HBV infection (relative risk (RR) 1.43, 95% confidence interval (CI) 1.26–1.63; Table 3)

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Summary

Introduction

Hepatitis B virus (HBV) is a serious and prevalent health problem: an estimated 257 million people live with HBV infection worldwide [1]. HBV is endemic in China, where there are 93 million hepatitis B surface antigen (HBsAg) carriers and 25 million chronically infected patients, according to the most recent national HBV seroprevalence data from 2006 [2,3]. HBV infection is associated with substantial health risks, since approximately 5% of adults with acute or asymptomatic HBV infection become chronically infected, and individuals infected with this virus are at increased risk of developing hepatic decompensation, cirrhosis, and hepatocellular carcinoma [4,5]. The most likely route of spread is percutaneous or mucosal exposure to blood or body fluids from infected patients and carriers [4]. HBV can remain stable on environmental surfaces for more than 7 days [7,8]

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