Association between gallbladder stones and chronic hepatitis C: Ultrasonographic survey in a hepatitis C and B hyperendemic township in Taiwan

Abstract

Gallbladder (GB) stones have been associated with several metabolic factors and liver diseases. This community-based study aimed at investigating the prevalence rate of GB stones and its associated factors in a hepatitis B virus (HBV)/hepatitis C virus (HCV)-endemic township in southern Taiwan. A total of 1701 residents (689 males and 1012 females; mean age: 51.2 ± 16.0 years) were enrolled in this prospectively designed screening project. Serum biochemistry tests, including testing for levels of serum aspartate aminotransferase, alanine aminotransferase (ALT), hepatitis B surface antigen (HBsAg), and antibody to HCV (anti-HCV) were conducted. In addition, a hepatobiliary ultrasonographic (US) examination was also conducted. Of the 1701 residents, 243 (14.3%) and 475 (27.9%) were found to be positive for HBsAg and anti-HCV, respectively. Results of the US examination revealed the prevalence rate of GB stone and fatty liver to be 6.8% and 55.6%, respectively. Using univariate analyses we found that significantly higher proportions of the participants with GB stone were male, over 50 years of age, positive for anti-HCV (p = 0.001, p < 0.001, and p = 0.001, respectively), with significantly higher mean age and ALT level (p ≤ 0.001 and p = 0.048, respectively) than did those without GB stone. By applying multivariate analyses, male gender, positive anti-HCV, and older age (>50 year) were identified as independent factors associated with the formation of GB stones. Anti-HCV was associated with GB stones in males but not in females in both univariate and multivariate analyses. GB stones were found to have a prevalence rate of 6.8% in this HCV/HBV hyperendemic township and are associated with higher mean age. A correlation between chronic hepatitis C and GB stones is observed only among males.

Hepatitis C virus infection and risk of gallstones: A meta-analysis

“…was more comprehensive and had a larger number of participants. Therefore, 11 studies (seven cross‐sectional studies, three case‐control studies, and one cohort study) were included in the data analysis . Figure outlines the literature review and study selection process.…”

“…Second, we performed a sensitivity analysis to explore the high heterogeneity in the overall analysis. We suspected that the difference in study design was the main source of heterogeneity, and therefore, performed a sensitivity analysis including only cross‐sectional studies . The I 2 from this sensitivity analysis decreased substantially to 21%, while the pooled OR was not significantly altered (pooled OR 1.53; 95% CI, 1.33 to 1.76).…”

“…It is estimated that approximately 180 million patients across the world are infected with this virus . HCV infection could also be an independent risk factor for gallstones as suggested by some epidemiologic studies . Some studies suggested that chronic inflammation of gallbladder epithelium from HCV is accountable for the increased prevalence.…”

Rapid resolution of extreme gallbladder wall thickening in a patient with acute hepatitis C

“…There is a well-known correlation between gallbladder wall thickening and acute hepatitis with an incidence of up to 63% [7] . There is also some evidence showing a higher incidence of primary gallbladder disease in patients with hepatitis C infection [8] . A number of mechanisms have been suggested for this including altered gallbladder mucosal function and altered dysmotility [8] .…”

“…There is also some evidence showing a higher incidence of primary gallbladder disease in patients with hepatitis C infection [8] . A number of mechanisms have been suggested for this including altered gallbladder mucosal function and altered dysmotility [8] . One theory is that these functional changes of the gallbladder are due to direct infection of the gallbladder itself from the hepatitis C virus, which is independent of the level of concurrent liver cirrhosis [9] .…”