The Hepatitis B Core Antibody Positive/hepatitis B Surface Antigen Negative Pattern is Associated with the Increased Risk of Intracranial Atherosclerotic Stenosis

Overview

Journal Medicine (Baltimore)

Specialty General Medicine

Date 2020 Jan 9

PMID 31914096

Authors

Lin Shen

Huchuan Zhou

Fei Wei

Jie Shuai

Affiliations

Soon will be listed here.

Abstract

The high prevalence of hepatitis B virus (HBV) infection and intracranial atherosclerotic stenosis (ICAS) in Asia raises the question as to whether HBV infection is associated with ICAS. To answer this question, we tested the association between HBV infection and ICAS. Totally, 3072 in-hospital subjects were retrospectively enrolled. All subjects underwent computed tomography angiography (CTA) and serological testing for HBV infection. Based on the results of CTA, all subjects were categorized into 4 groups including ICAS, extracranial atherosclerotic stenosis (ECAS), ICAS/ECAS (both ICAS and ECAS), and normal. HBV infection was divided into 4 patterns including hepatitis B core antibody (anti-HBc) positive/hepatitis B surface antigen (HBsAg) positive, anti-HBc-positive/HBsAg-negative, anti-HBc-negative/HBsAg-positive, and anti-HBc-negative/HBsAg-negative. Risk factors for atherosclerosis were collected based on medical records. Multiple logistic regression models were used to determine the association between infection patterns and ICAS. We found that the anti-HBc-positive / HBsAg-negative pattern was associated with the increased risk of ICAS (OR = 1.462) and not associated with ECAS or ICAS / ECAS. The HBc-positive/HBsAg-positive pattern was not associated with ICAS, ECAS or ICAS/ECAS. In conclusions, the anti-HBc-positive/HBsAg-negative pattern was associated with the increased risk of ICAS. Anti-HBc should be employed to investigate the association between HBV infection and cerebrovascular diseases.

References

Kim J, Park M, Nam T, Choi S, Lee S, Kim B . Multiple cerebral arterial stenosis associated with hepatitis B virus infection. J Clin Neurol. 2011; 7(1):40-2. PMC: 3079159. DOI: 10.3988/jcn.2011.7.1.40. View

Zhang Y, Fang W, Fan L, Gao X, Guo Y, Huang W . Hepatitis B surface antigen prevalence among 12,393 rural women of childbearing age in Hainan Province, China: a cross-sectional study. Virol J. 2013; 10:25. PMC: 3626832. DOI: 10.1186/1743-422X-10-25. View

Tseng C, Muo C, Hsu C, Kao C . Association of hepatitis B virus infection with decreased ischemic stroke. Acta Neurol Scand. 2016; 134(5):339-345. DOI: 10.1111/ane.12548. View

Epstein S, Zhu J, Burnett M, Zhou Y, Vercellotti G, Hajjar D . Infection and atherosclerosis: potential roles of pathogen burden and molecular mimicry. Arterioscler Thromb Vasc Biol. 2000; 20(6):1417-20. DOI: 10.1161/01.atv.20.6.1417. View

VELICAN C . Studies on the age-related changes occurring in human cerebral arteries. Atherosclerosis. 1970; 11(3):509-29. DOI: 10.1016/0021-9150(70)90029-8. View

Arenillas J, Molina C, Chacon P, Rovira A, Montaner J, Coscojuela P . High lipoprotein (a), diabetes, and the extent of symptomatic intracranial atherosclerosis. Neurology. 2004; 63(1):27-32. DOI: 10.1212/01.wnl.0000132637.30287.b4. View

Ott J, Stevens G, Groeger J, Wiersma S . Global epidemiology of hepatitis B virus infection: new estimates of age-specific HBsAg seroprevalence and endemicity. Vaccine. 2012; 30(12):2212-9. DOI: 10.1016/j.vaccine.2011.12.116. View

Pu Y, Dou X, Liu L . Natural history of intracranial atherosclerotic disease. Front Neurol. 2014; 5:125. PMC: 4091030. DOI: 10.3389/fneur.2014.00125. View

Lei C, Wu B, Liu M, Chen Y . Risk factors and clinical outcomes associated with intracranial and extracranial atherosclerotic stenosis acute ischemic stroke. J Stroke Cerebrovasc Dis. 2013; 23(5):1112-7. DOI: 10.1016/j.jstrokecerebrovasdis.2013.09.024. View

10.

Moossy J . Morphology, sites and epidemiology of cerebral atherosclerosis. Res Publ Assoc Res Nerv Ment Dis. 1966; 41:1-22. View

11.

Kim J, Nah H, Park S, Kim S, Cho K, Lee J . Risk factors and stroke mechanisms in atherosclerotic stroke: intracranial compared with extracranial and anterior compared with posterior circulation disease. Stroke. 2012; 43(12):3313-8. DOI: 10.1161/STROKEAHA.112.658500. View

12.

Qureshi A, Caplan L . Intracranial atherosclerosis. Lancet. 2013; 383(9921):984-98. DOI: 10.1016/S0140-6736(13)61088-0. View

13.

Elkind M, Luna J, Moon Y, Boden-Albala B, Liu K, Spitalnik S . Infectious burden and carotid plaque thickness: the northern Manhattan study. Stroke. 2010; 41(3):e117-22. PMC: 2830875. DOI: 10.1161/STROKEAHA.109.571299. View

14.

Solberg L, McGarry P, Moossy J, Tejada C, LOKEN A, Robertson W . Distribution of cerebral atherosclerosis by geographic location, race, and sex. Lab Invest. 1968; 18(5):604-12. View

15.

Sacco R, Kargman D, Gu Q, Zamanillo M . Race-ethnicity and determinants of intracranial atherosclerotic cerebral infarction. The Northern Manhattan Stroke Study. Stroke. 1995; 26(1):14-20. DOI: 10.1161/01.str.26.1.14. View

16.

Sung J, Song Y, Choi Y, Ebrahim S, Davey Smith G . Hepatitis B virus seropositivity and the risk of stroke and myocardial infarction. Stroke. 2007; 38(5):1436-41. DOI: 10.1161/STROKEAHA.106.466268. View

17.

RESCH J, Okabe N, Loewenson R, Kimoto K, Katsuki S, Baker A . A comparative study of cerebral atherosclerosis in a Japanese and Minnesota population. J Atheroscler Res. 1967; 7(5):687-93. DOI: 10.1016/s0368-1319(67)80044-9. View

18.

Rosenfeld M, Campbell L . Pathogens and atherosclerosis: update on the potential contribution of multiple infectious organisms to the pathogenesis of atherosclerosis. Thromb Haemost. 2011; 106(5):858-67. DOI: 10.1160/TH11-06-0392. View

19.

CORNISH B, Paterson J . Calcium concentrations in sclerotic cerebral arteries. AMA Arch Pathol. 1956; 62(3):177-82. View

20.

Wityk R, Lehman D, Klag M, Coresh J, Ahn H, Litt B . Race and sex differences in the distribution of cerebral atherosclerosis. Stroke. 1996; 27(11):1974-80. DOI: 10.1161/01.str.27.11.1974. View