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Current Medical Science

, Volume 38, Issue 4, pp 610–617 | Cite as

Elevated Arsenic Exposure Is Associated with an Increased Risk of Chronic Hepatitis B Virus Infection: NHANES (2003–2014) in U.S. Adults

  • Wei-hua Zhang
  • Jiao Huang
  • Mei Feng
  • Ye-qing Tong
  • Xu-hua Guan
  • Hong-wei Jiang
  • Sheng Wei
Article

Summary

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 words

arsenic exposure hepatitis B infection National Health and Nutrition Examination Survey 

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References

  1. 1.
    Shakoor MB, Nawaz R, Hussain F, et al. Human health implications, risk assessment and remediation of As-contaminated water: A critical review. Sei Total Environ, 2017, 601–602:756CrossRefGoogle Scholar
  2. 2.
    Nachman KE, Baron PA, Räber G, et al. Roxarsone, inorganic arsenic, and other arsenic species in chicken: a U.S.-based market basket sample. Environ Health Perspect, 2013, 121(7):818–824CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Nigra AE, Nachman KE, Love DC, et al. Poultry consumption and arsenic exposure in the U.S. population. Environ Health Perspect, 2017, 125(3):370–377CrossRefPubMedGoogle Scholar
  4. 4.
    Rahman A, Vahter M, Ekstrom EC, et al. Arsenic exposure in pregnancy increases the risk of lower respiratory tract infection and diarrhea during infancy in Bangladesh. Environ Health Perspect, 2011, 119(5):719–724CrossRefPubMedGoogle Scholar
  5. 5.
    Raqib R, Ahmed S, Sultana R, et al. Effects of in utero arsenic exposure on child immunity and morbidity in rural Bangladesh. Toxicol Lett, 2009, 185(3):197–202CrossRefPubMedGoogle Scholar
  6. 6.
    Heaney CD, Kmush B, Navas-Acien A, et al. Arsenic exposure and hepatitis E virus infection during pregnancy. Environ Res, 2015, 142:273–280CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Cardenas A, Smit E, Bethel JW, et al. Arsenic exposure and the seroprevalence of total hepatitis A antibodies in the US population: NHANES, 2003–2012. Epidemiol Infect, 2016, 144(8):1641–1651CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Cardenas A, Smit E, Houseman EA, et al. Arsenic exposure and prevalence of the varicella zoster virus in the United States: NHANES (2003–2004 and 2009–2010). Environ Health Perspect, 2015, 123(6):590–596CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Schweitzer A, Horn J, Mikolajczyk RT, et al. Estimations of worldwide prevalence of chronic hepatitis B virus infection: a systematic review of data published between 1965 and 2013. Lancet, 2015, 386(10003):1546–1555CrossRefPubMedGoogle Scholar
  10. 10.
    de Martel C, Maucort-Boulch D, Plummer M, et al. World-wide relative contribution of hepatitis B and C viruses in hepatocellular carcinoma. Hepatology, 2015, 62(4):1190–1200CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Fattovich G, Bortolotti F, Donato F. Natural history of chronic hepatitis B: special emphasis on disease progression and prognostic factors. J Hepatol, 2008, 48(2):335–352CrossRefPubMedGoogle Scholar
  12. 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. 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. 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
  15. 15.
    Krueger WS, Wade TJ. Elevated blood lead and cadmium levels associated with chronic infections among non-smokers in a cross-sectional analysis of NHANES data. Environ Health, 2016, 15:16CrossRefPubMedPubMedCentralGoogle Scholar
  16. 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. 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. 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. 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.
  20. 20.
    Frediani Ж, Naioti EA, Vos MB, et al. Arsenic exposure and risk of nonalcoholic fatty liver disease (NAFLD) among U.S. adolescents and adults: an association modified by race/ethnicity, NHANES 2005–2014. Environ Health, 2018, 17(1):6CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Murer AJ, Abildtrup A, Poulsen OM, et al. Effect of seafood consumption on the urinary level of total hydride-generating arsenic compounds. Instability of arsenobetaine and arsenocholine. Analyst, 1992, 117(3):677–680CrossRefPubMedGoogle Scholar
  22. 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.
  23. 23.
    Sheehan MC, Burke TA, Breysse PN, et al. Association of markers of chronic viral hepatitis and blood mercury levels in US reproductive-age women from NHANES 2001–2008: a cross-sectional study. Environ Health, 2012, 11(1):62CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Alan A. Categorical Data Analysis, 3rd edition. Statistical Methods & Applicaticms, 2002, 14(1):109–109Google Scholar
  25. 25.
    Kuo CC, Weaver V, Fadrowski JJ, et al. Arsenic exposure, hyperuricemia, and gout in US adults. Environ Int, 2015, 76:32–40CrossRefPubMedGoogle Scholar
  26. 26.
    Banerjee N, Baneijee S, Sen R, et al. Chronic arsenic exposure impairs macrophage functions in the exposed individuals. J Clin Immunol, 2009, 29(5):582–594CrossRefPubMedGoogle Scholar
  27. 27.
    Burns LA, McCay JA, Brown R, et al. Arsenic in the sera of gallium arsenide-exposed mice inhibits bacterial growth and increases host resistance. J Pharmacol Exp Ther, 1993, 265(2):795–800PubMedGoogle Scholar
  28. 28.
    Hernandez-Castro B, Doniz-Padilla LM, Salgado-Bustamante M, et al. Effect of arsenic on regulatory T cells. J Clin Immunol, 2009, 29(4):461–469CrossRefPubMedGoogle Scholar
  29. 29.
    Biswas R, Ghosh P, Banerjee N, et al. Analysis of T-cell proliferation and cytokine secretion in the individuals exposed to arsenic. Hum Exp Toxicol, 2008, 27(5):381–386CrossRefPubMedGoogle Scholar
  30. 30.
    Soto-Pena GA, Luna AL, Acosta-Saavedra L, et al. Assessment of lymphocyte subpopulations and cytokine secretion in children exposed to arsenic. FASEB J, 2006, 20(6):779–781CrossRefPubMedGoogle Scholar
  31. 31.
    Ahmed S, Moore SE, Kippler M, et al. Arsenic exposure and cell-mediated immunity in preschool children in rural Bangladesh. Toxicol Sei, 2014, 141(1):166–175CrossRefGoogle Scholar
  32. 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. 33.
    Dangleben NL, Skibola CF, Smith MT. Arsenic immunotoxicity: a review. Environ Health, 2013, 12(1):73Google Scholar
  34. 34.
    Mitchell AM, Li C, Samulski RJ. Arsenic trioxide stabilizes accumulations of adeno-associated virus virions at the perinuclear region, increasing transduction in vitro and in vivo. J Virol, 2013, 87(8):4571–4583CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    Drobna Z, Walton FS, Paul DS, et al. Metabolism of arsenic in human liver: the role of membrane transporters. Arch Toxicol, 2010, 84(1):3–16CrossRefPubMedGoogle Scholar
  36. 36.
    Benramdane L, Accominotti M, Fanton L, et al. Arsenic speciation in human organs following fatal arsenic trioxide poisoning~a case report. Clin Chem, 1999, 45(2):301–306PubMedGoogle Scholar
  37. 37.
    Bustaffa E, Stoccoro A, Bianchi F, et al. Genotoxic and epigenetic mechanisms in arsenic carcinogenicity. Arch Toxicol, 2014, 88(5):1043–1067CrossRefPubMedGoogle Scholar
  38. 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. 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
  40. 40.
    Mazumder DN. Effect of chronic intake of arsenic-contaminated water on liver. Toxicol Appl Pharmacol, 2005, 206(2):169–175CrossRefPubMedGoogle Scholar
  41. 41.
    Shi X, Wei X, Koo I, et al. Metabolomic analysis of the effects of chronic arsenic exposure in a mouse model of diet-induced fatty liver disease. J Proteome Res, 2014, 13(2):547–554CrossRefPubMedGoogle Scholar
  42. 42.
    Huang YK, Tseng CH, Huang YL, et al. Arsenic methylation capability and hypertension risk in subjects living in arseniasis-hyperendemic areas in southwestern Taiwan. Toxicol Appl Pharmacol, 2007, 218(2):135–142CrossRefPubMedGoogle Scholar
  43. 43.
    Shouval D, Shibolet O. Immunosuppression and HBV reactivation. Semin Liver Dis, 2013, 33(2):167–177CrossRefPubMedGoogle Scholar

Copyright information

© Huazhong University of Science and Technology 2018

Authors and Affiliations

  1. 1.Department of Epidemiology and Biostatistics, Key Laboratory of Environment and Health of Ministry of Education, School of Public Health, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
  2. 2.Department of Preventive Medicine, School of MedicineNingbo UniversityNingboChina
  3. 3.Institute of Infectious Disease Control and PreventionHubei Provincial Center for Disease Control and PreventionWuhanChina

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