Elevated Arsenic Exposure Is Associated with an Increased Risk of Chronic Hepatitis B Virus Infection: NHANES (2003–2014) in U.S. Adults
Studies concerning the association between arsenic exposure and hepatitis B virus (HB V) infection have been lacking. The present study aimed to examine the association between total urinary arsenic (TUA) and infection of HBV. A total of 5186 participants from National Health and Nutrition Examination Survey (NHANES) 2003–2014 were included in the analysis. We used logistic regression to evaluate the association. We defined two measures of TUA. TUAI was the sum of arsenous acid, arsenicacid, monomethylarsonic acid and dimethylarsenic acid. TUA2 was defined as TUA minus arsenobetaine and arsenocholine. The results showed that the weighted overall prevalence of HBV infection was 6.08%. For NHANES 2003–2014, the medians (interquartile range) of TUAI and TUA2 were 5.60 μg/L (3.97–8.09 μg/L) and 4.91 μg/L (2.36–9.11 μg/L), respectively. Comparing the highest quartile to the lowest quartile after multivariable adjustment showed that the odds ratios (ORs) and 95% confidence intervals (CIs) for TUAI and TUA2 were 2.44 (1.40–4.27) and 2.84 (1.60–5.05), respectively. In conclusion, elevated urinary arsenic was associated with the risk of HBV infection. Further studies, especially prospective studies, are needed to confirm the causal relationship between arsenic exposure and HBV infection.
Key wordsarsenic exposure hepatitis B infection National Health and Nutrition Examination Survey
Unable to display preview. Download preview PDF.
- 12.Wasley A, Grytdal S, Gallagher K. Surveillance for acute viral hepatitis-United States, 2006. MMWR Surveill Summ, 2008, 57(2):l–24Google Scholar
- 13.CDC. About the National Health and Nutrition Examination Survey: Introduction. Available: https://doi.org/www.cdc.gov/nchs/nhanes/about_nhanes.htm [accessed 11 October 2017]. 2014.
- 14.CDC. National Center for Health Statistics: National Health and Nutrition Examination Survey: Analytic Guidelines, 1999–2010. Centers for Disease Control and Prevention 2013.Google Scholar
- 16.NCHS: Laboratory Procedure Manual, Hepatitis B Core Antibody. Available: https://doi.org/wwwn.cdc.gov/nchs/data/nhanes/2013-2014/labmethods/HEPBD_H_Hepatitis%20B%20core%20antibody_met.pdf [accessed 24 October 2017] 2014.
- 17.Caldwell KL, Jones RL, Verdon CP, et al. Levels of urinary total and speciated arsenic in the US population: National Health and Nutrition Examination Survey 2003–2004. J Expo Sei Environ Epidemiol, 2009, 19(1):59–68Google Scholar
- 18.NCHS: Laboratory Procedure Manual, Total Arsenic. Available: https://doi.org/wwwn.cdc.gov/nchs/data/nhanes/2013-2014/labmethods/UM_UMS_UTAS_UTASS_H_MET.pdf [accessed 24 October 2017]. 2014.
- 19.NCHS: Laboratory Procedure Manual, Urinary speciated arsenics. Available: https://doi.org/wwwn.cdc.gov/nchs/data/nhanes/2013-2014/labmethods/UAS_UASS_H_MET.pdf [accessed 24 October 2017] 2014.
- 22.NCHS: Laboratory Procedure Manual, Urinary Creatinine. Available: https://doi.org/wwwn.cdc.gov/nchs/data/nhanes/2013-2014/labmethods/BIOPRO_H_MET_CREATININE.pdf [accessed 24 October 2017] 2014.
- 24.Alan A. Categorical Data Analysis, 3rd edition. Statistical Methods & Applicaticms, 2002, 14(1):109–109Google Scholar
- 32.Lin X, Xu X, Zeng X, et al. Decreased vaccine antibody liters following exposure to multiple metals and metalloids in e-waste-exposed preschool children. Environ Pollut, 2017, 220(Pt A):354–363Google Scholar
- 33.Dangleben NL, Skibola CF, Smith MT. Arsenic immunotoxicity: a review. Environ Health, 2013, 12(1):73Google Scholar
- 38.Tokar EJ, Kojima C, Waalkes MP. Methylarsonous acid causes oxidative DNA damage in cells independent of the ability to biomethylate inorganic arsenic. Arch Toxicol, 2014, 88(2):249–261Google Scholar
- 39.Zhang Z, Gao L, Cheng Y, et al. Resveratrol, a natural antioxidant, has a protective effect on liver injury induced by inorganic arsenic exposure. Biomed Res Int5 2014, 2014:617202Google Scholar