Familial aggregation and clinical prognosis of hepatitis B virus infection in Guangzhou,China

Objective To investigate the characteristics of familial aggregation and prognosis of chronic hepatitis B( CHB) in Guangzhou,China,where there is a high prevalence of hepatitis B virus( HBV) infection. Methods The CHB patients who were treated in Outpatient Department of Hepatitis in the First Affiliated Hospital of Sun Yat- sen University from January 2009 to April 2016 were enrolled. The basic demographic features,relatives' HBV markers,patients' HBV indices,liver biochemical parameters,and findings on liver color Doppler ultrasound,computed tomography( CT),and magnetic resonance imaging( MRI) were analyzed. Familial aggregation was defined as at least two relatives diagnosed with chronic HBV infection,and the clinical features were compared between the groups with and without familial aggregation. The t- test was used for comparison of normally distributed continuous data between groups,and the Wilcoxon rank sum test was used for non- normally distributed continuous data between groups. The chi- square test or Fisher' s exact test was used for comparison of categorical data between groups. The univariate logistic regression was used to analyze familial aggregation and the risk factors for HBV infection,liver cirrhosis,and liver cancer in offspring. Results A total of 1096 CHB patients with a clear family history were enrolled; among these patients,569 had a positive family history,resulting in a rate of familial aggregation of 51. 9%. According to their age,the patients were stratified into groups of 16- 30 years,31- 45 years,and > 46 years. The proportions of patients diagnosed with liver cirrhosis across the three age stratifications in the groups with and without familial aggregation were 2. 1% /11. 5% /35. 6% and 2. 7% /5. 7% /38. 5%,respectively. The group with familial aggregation had a significantly higher proportion of patients aged 31- 45 years who were diagnosed with liver cirrhosis than the group without familial aggregation( χ2= 5. 71,P = 0. 02). The familial aggregation pattern was dominated by infection between siblings( 30. 2%) and mother- children infection( 34. 4%). Maternal and paternal infection( OR = 8. 18,95% CI: 5. 24-12. 75),maternal infection alone( OR = 4. 60,95% CI: 3. 69- 5. 74),and paternal infection alone( OR = 2. 77,95% CI: 2. 11- 3. 63)were associated with HBV infection in offspring. Familial aggregation pattern was not the risk factor for the development of liver cirrhosis in patients( P > 0. 05),while maternal and paternal infection( OR = 8. 5,P < 0. 01) was the risk factor for the development of liver cancer.Conclusion CHB infection shows high familial aggregation in Guangzhou,and the patients with a positive family history of CHB may progress to liver cirrhosis early.