Prevalence of Hepatitis B Carrier Status and Its Negative Association with Hypertensive Disorders in Pregnancy

Abstract

Background and Objectives. To evaluate whether a negative association between chronic hepatitis B carrier status and hypertensive disorders in pregnancy could continue to be demonstrated in an endemic area with a changing prevalence for chronic hepatitis B infection. Study Design. A retrospective cohort of all deliveries in a single centre over a period of 20 years in a population with high prevalence for chronic hepatitis B carrier status was studied. Main Outcome Measures. The primary outcome was the prevalence of chronic HBV carrier status and gestational hypertensive disorders in pregnancy during the study period. The secondary outcome measures included the major risk factors for gestational hypertensive disorders. The overall association between HBV carrier status and gestational hypertensive disorders and the association with major risk factors were then evaluated. Results. In a total cohort of 87889 deliveries over a period of 20 years, the prevalence rate of HBV fell from around 10-11% to around 6-7% in the last 5 years of the study. A negative association between chronic HBV carrier status and all gestational hypertensive disorders could be demonstrated. An apparent protective effect of HBV carrier status was apparently more robust against preeclampsia than gestational hypertension, as the negative association with preeclampsia was consistently observed throughout the study period. A logistic regression model showed that advanced maternal age, multiple pregnancies, obesity, and significant medical disorders were positively correlated with gestational hypertensive disorders, while multiparity and positive HBV carrier status were negatively correlated. Conclusion. Chronic HBV carrier status appeared to have a protective effect against the development of preeclampsia and gestational hypertension in an endemic area with high HBV prevalence rates.

Changing prevalence of chronic hepatitis B virus infection in China between 1973 and 2021: a systematic literature review and meta-analysis of 3740 studies and 231 million people

“…However, only a small number of studies (n=13) were included for Hong Kong, with few data prior to 1993. Of note, a very recently published study that has been included in our meta-analysis reported an approximately 50% reduction (10.0% to 5.3%) in HBsAg prevalence in Hong Kong between 2000 and 2019, 37 suggesting that HBsAg, although still relatively high compared with other regions of China, is also decreasing in Hong Kong.…”

Prevalence of hepatitis B virus infection among pregnant women in the mountainous regions of southern China: A retrospective single‐center study

“…However, other studies did not identify such an association or had contrasting results. 40 Patients with elevated ALT levels before treatment had a higher incidence of post‐partum hepatitis flare. 41 , 42 Our results found that HBsAg‐positive participants, particularly those who are HBeAg carriers, had significantly high ALT levels.…”

“…Previous studies have shown that HBV infection does not affect the development of preeclampsia, 27,39 and our result is in accordance with this finding. However, other studies did not identify such an association or had contrasting results 40 . Patients with elevated ALT levels before treatment had a higher incidence of post‐partum hepatitis flare 41,42 .…”

Trends and future projections of liver cancer incidence in Hong Kong: a population-based study

“…It suggests that the efforts to prevent and control hepatitis B have been effective. In Hong Kong, the seroprevalence of hepatitis B surface antigen (HBsAg) has declined in several populations with no obvious HBV risk, such as new blood donors and pregnant women [ 24 ]. Hong Kong has transitioned from a high-intermediate to an intermediate-low hepatitis B endemicity over the last few decades.…”