Epidemiological Characteristics Of HBV And HCV Infection In Jilin And The Relationship Between Polymorphisms Of PNPLA3 And TM6SF2 And Fatty Liver In HBV Infection

SECTION 1 The Epidemiological Characteristics of HBV and HCV Infection in JilinBackground:To investigate the epidemiology of hepatitis B and C infections and the benefits of programs aimed at hepatitis prevention and control in Northeastern China.Methods:Individuals receiving health examinations were recruited to undergo laboratory tests for hepatitis infection.Data on demographic characteristics,results of hepatitis B virus(HBV)and hepatitis C virus(HCV)serological tests,for HBV and HCV infection were analyzed.Results:Among 227 808 study participants,the hepatitis B surface antigen(HBs Ag)and anti-HCV–positive rates were 6.1% and 3.0%,respectively.Among HBs Ag-positive participants,63.8% tested positive for HBV DNA,20.2% had an abnormal alanine aminotransferase(ALT)level,and 10.7% had cirrhosis.Among anti-HCV–positive participants,57.2% tested positive for HCV RNA,29.6% had an abnormal ALT level,and 8.4% had cirrhosis.Among HBs Ag-or anti-HCV–positive participants,47.1% and 32.0%,respectively,were aware of their infection.Among participants infected with HBV or HCV and suitable for antivirus treatment,23.5% and 16.1%,respectively,had received antivirus treatment.The HBV plus HCV coinfection rate was 0.08%.Conclusions:The HBs Ag-positive rate decreased significantly after implementation of recently introduced HBV control programs in China.However,the anti-HCV–positive rate showed only a slight decrease,indicating that programs for the prevention and control of hepatitis viruses require continued strengthening.Chinese Clinical Trials Registration.Chi CTR-ECS-13004009.SECTION 2 The relationship between polymorphisms of PNPLA3 and TM6SF2 and fatty liver in HBV infectionObjective:To determine PNPLA3 and TM6SF2 gene polymorphism in HBV infection and the on the relationship between polymorphisms of PNPLA3 and TM6SF2 and fatty liver in HBV infection.Methods:5% samples of statistical random sampling from the HBs Ag positive people from the large epidemiological survey were included in the study.In the case of informed consent,the PNPLA3 and TM6SF2 gene polymorphisms were extracted from serum samples and physical history data collected before.According to whether HBV infection combined with fatty liver was divided into fatty liver group and simple HBV infection group.The differences in serum biochemical level,virus level and polymorphism of Fibscan,PNPLA3 and TM6SF2 genes in the two groups were compared.Results:There were 976 cases of HBV infection,of which 830 cases were simple HBV infection(85.04%),146 cases were HBV combined with fatty liver(14.96%).The levels of ALT,AST,GGT,TG,CHOL,blood glucose,BMI,HOMA-IR and CAP in HBV patients with fatty liver were significantly higher than those in simple HBV infection.The proportion of PNPLA3 non CC type in HBV combined with fatty liver was 63.01%,which was significantly higher than that in patients with simple HBV infection,P<0.05.The proportion of TM6SF2 non CC in HBV combined with fatty liver was 17.81%,which was significantly higher than that in patients with simple HBV infection.Among the HBV patients with fatty liver,the CAP value of PNPLA3 non CC type was significantly higher than that of CC type,and CAP value of TM6SF2 non CC type was also significantly higher than that of CC type.The CAP value of PNPLA3 and TM6SF2 with non CC in HBV with fatty liver was the highest,obviously higher than the other three groups.PNPLA3 and TM6SF2 were the lowest in CC type,obviously lower than the other three groups.Among the patients with HBV with fatty liver,the proportion of PNPLA3 non CC type F3-4 was significantly higher than that of CC type,P<0.05,TM6SF2 CC type and non CC type F3-4,P>0.05.There was no significant difference in HBV infection among all groups.Whether in HBV with fatty liver or HBV infection,the PNPLA3 and TM6SF2 gene polymorphisms were not significantly correlated with the positive rate of HBV DNA.Among the HBV patients with fatty liver,the level of HBV DNA in PNPLA3 non CC patients was significantly lower than that in CC type,while HBV CC level in TM6SF2 non CC type was significantly higher than that in CC type,and the level of HBV < 0.05.In HBV infected individuals,PNPLA3 and TM6SF2 gene polymorphisms were not significantly correlated with HBV DNA levels.The PNPLA3 and TM6SF2 gene polymorphisms were not significantly synergistic in the positive rate of HBV DNA and the level of HBV DNA in both HBV with fatty liver or simple HBV infection.Male,BMI > 25,blood glucose >6.1 umol/l,CHOL>6.0 umol/l,TG>1.7 umol/l,PNPLA non CC and TM6SF2 non CC were the risk factors of fatty liver with HBV infection.Conclusion:1.In HBV-infected patients with fatty liver,the PNPLA3 and TM6SF2 gene polymorphisms were associated with the severity of fatty liver,and there was synergy between the two groups.2,In HBV with fatty liver,the proportion of F3-4 in PNPLA3 non CC is significantly higher than that in CC group.3,In HBV with fatty liver,PNPLA3 CC type HBV DNA level was significantly higher than non CC type,while TM6SF2 CC type HBV DNA level was significantly lower than non CC type.4,PNPLA3 non CC and TM6SF2 non CC are independent risk factors for fatty liver in HBV infected patients.