HEPATITIS-C VIRUS-INFECTION AS A RISK FACTOR FOR NONALCOHOLIC LIVER-CIRRHOSIS IN TAIWAN

To assess whether hepatitis C virus infection was a risk factor for th e development of non-alcoholic liver cirrhosis, antibody to hepatitis C virus (anti HCV; detected by a second generation HCV enzyme immunoas say), hepatitis B surface antigen (HBsAg; detected by radioimmunoassay ) were tested in 150 cirrhotics and 150 sex-matched and age-matched he althy controls. The prevalence of anti-HCV and HBsAg in cirrhotics was higher than in controls (22.0%, 73.3% vs. 2%, 18.7%; P = 0.001). The prevalence of anti-HCV in HBsAS-negative cirrhotics (45.0%) was higher than that in HBsAg-positive patients (13.6%; P = 0.001). Both the ant i-HCV and carriage of HBsAS were associated significantly with liver c irrhosis, showing odds ratio of 12.0 for HBsAg carriers and 13.8 for p atients with anti-HCV. Compared with those without HBsAg and anti-HCV, there was a significantly positive linear trend for developing cirrho sis with the presence of HBsAg alone (odds ratio = 19.9), anti-HCV alo ne (odds ratio = 49.0), and those positive for HBsAg and anti-HCV (odd s ratio = 81.8) (P = 0.00001). The population-attributable risk for de veloping liver cirrhosis was estimated as 10.8% for anti-HCV alone, 55 .2% for HBsAg alone, and 9.4% for both anti-HCV and HBsAg in southern Taiwan. In conclusion, this study shows that hepatitis B and C virus i nfection act independently and synergistically in the development of n on-alcoholic liver cirrhosis among Chinese in Taiwan. (C) 1993 wiley-L iss, Inc.