Changing aetiology of liver dysfunction in the new generation of a hepatitis B and C-endemic area: cross-sectional studies on adolescents born in the first 10 years after universal hepatitis B vaccination.

Abstract

BACKGROUND/AIM:

Geographical variation in viral hepatitis infection complicates various levels of liver diseases. This study elucidates the changing aetiology of alanine transaminase elevation (ALT levels >40 IU/L) in a previously hepatitis-endemic township.

DESIGN/METHODS:

Five cross-sectional screenings were performed on teenagers born from 1984 to 1993. We examined hepatitis B surface antigen (HBsAg), anti-hepatitis C virus (anti-HCV), ALT and body mass index, and additionally checked hepatitis B envelope antigen (HBeAg) for positive HBsAg and HCV RNA for positive anti-HCV. Teenagers with ALT elevation underwent an ultrasonography examination.

RESULTS:

This study enrolled 1788 (93.7%) of 1909 students, discovering individual prevalence of HBsAg (6.3%), anti-hepatitis B core (anti-HBc) (15.5%), anti-HCV (2.2%), overweight (22.4%), obesity (12.8%) and ALT >40 IU/L (3.7%). HBsAg and anti-HBc prevalence declined with trends, while obesity increased with trends (P<0.001). Among 66 ALT-elevated teenagers, prevalence percentages of risk factors were HBsAg (22.7%), anti-HCV (1.5%), obesity (45.5%), HBsAg with obesity (7.6%) and anti-HCV with obesity (3.0%). Additionally, obesity showed predominance (85.7%) among aetiologies of teenagers with fatty livers (60.9%). The independently associated factors of ALT elevation included being male (odds ratio, 2.18; 95% confidence interval, 1.21-3.93), HBsAg (4.25; 1.06-17.13), HBeAg (7.24; 1.64-31.9), HCV RNA (29.03; 5.8-145.29) and obesity (16.5; 8.79-30.98).

CONCLUSION:

In place of viral hepatitis, obesity is becoming the major aetiology of abnormal liver function among the young generation in a previously hepatitis-endemic area.

• Authors: Jung-Ta Kao, Jing-Houng Wang, Chao-Hung Hung, Tsung-Hui Hu, Chuan-Mo Lee, Shu-Fen Hung, Sheng-Nan Lu
• Journal: Liver international : official journal of the International Association for the Study of the Liver (Liver Int) Vol. 28 Issue 9 Pg. 1298-304 (Nov 2008) ISSN: 1478-3231 [Electronic] United States
• PMID: 18662273 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Hepatitis B Vaccines
• Alanine Transaminase

Topics

• Adolescent
• Alanine Transaminase (blood)
• Body Mass Index
• Child
• Cross-Sectional Studies
• Endemic Diseases (prevention & control)
• Female
• Hepatitis B (epidemiology)
• Hepatitis B Vaccines
• Hepatitis C (epidemiology)
• Humans
• Liver Diseases (blood, etiology)
• Male
• Obesity (blood, complications)
• Prevalence
• Taiwan (epidemiology)