- Men with Hepatitis B are more likely to be affected with severe liver disease than women but the reason remains unclear.
- Men who are current drinkers had eight times the risk of developing liver disease and women who currently drink were four times as likely.
- Even when accounting for smoking and alcohol, sex was still a strong, independent indicator of liver disease risk in the hepatitis B patients.
Liver disease is one of the severe complications of Hepatitis B infection. Compared to women, liver disease is more common in men.
A recent Drexel University graduate took lifestyle choices and environments into account to find out the risks.
‘Patients infected with hepatitis B should still avoid alcohol, smoking - the risk factors and prevent liver disease progression.’
In an attempt to explain the disparity between the two, suggestions have been made that lifestyle choices, such as drinking, smoking or even how much water a person drinks, might be the reason.
But Jing Sun, PhD, a post-doctoral fellow at Johns Hopkins University and a graduate of Drexel's Dornsife School of Public Health, found no such evidence in her recent study. The best indicator for the severity of liver disease was found to be the patient's sex.
"Currently, there is no therapy that can cure hepatitis B infection. People infected with it have very different clinical outcomes: Some remain without symptoms throughout their lifetimes while others develop severe liver conditions, such as liver cancer, cirrhosis and liver failure. Predicting those who will eventually develop liver disease provides important information for intervention strategies," Sun explained.
Modifiable factors which include lifestyle choices, drinking habits were not associated with the risk of liver disease. Though these factors can be changed, there was no link.
But still, the study found that men with hepatitis B were just over twice as likely to develop severe liver disease as women
"Previous studies suggested males were two to four times more likely to develop liver cancer than females," Sun said. "In our study, we observed males were 2.08 times as likely. The magnitude of effect is within the range we would expect, then."
The study collected information from 1,863 men and women from the year 2003. Alcohol intake, smoking habits, beverage and water intake was also taken into account. It also used information from physical examinations, ultrasounds, and blood tests to determine liver disease condition, ranking from "normal" to "severe," which included cirrhosis and liver cancer.
Drinking alcohol was significantly tied to liver disease risk, and the study found that there was a difference between men and women. The risk of liver disease was 8 times in men who are current drinkers and women who currently drink were four times as likely.
Smoking was also found to increase risk for both men and women. Smoking increased the risk of disease development by 2 times.
But the study found that even when accounting for these different factors, sex was still a strong, independent indicator of liver disease risk in the hepatitis B patients. Men consistently were two times as likely as women to develop cirrhosis or liver cancer.
"Based on the results of animal studies done by other groups, we hypothesize such differences are due to other biological causes (e.g. sex hormones)," Sun said.
And while lifestyle or environmental risks for patients don't seem to explain the difference in liver disease in men and women who have hepatitis B, those factors aren't meaningless, either.
"Of course, even though the lifestyle difference between males and females cannot explain the gender difference, patients infected with hepatitis B should still avoid these risk factors to prevent liver disease progression," Sun concluded.
- Jing Sun et al., No contribution of lifestyle and environmental exposures to gender discrepancy of liver disease severity in chronic hepatitis b infection: Observations from the Haimen City cohort, PLOS ONE,(2017),https:doi.org/10.1371/journal.pone.0175482.