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Chronic viral hepatitis accelerates lung function decline in smokers

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Abstract

Although hepatitis B virus (HBV) and hepatitis C virus (HCV) are hepatotrophic viruses, they may affect pulmonary diseases. The purpose of this study was to assess whether chronic viral hepatitis (CVH) infection was associated with a rapid decline in lung function. Repeated measurements of lung function were obtained from a well-curated health check-up database. A case was defined as an individual positive for HBsAg or anti-HCV antibody. A control was randomly selected (from the same dataset) after 1:1 matching in terms of age, sex, height, the body mass index, and smoking status. Separate analyses of non-smokers and smokers were performed. A total of 701 cases were enrolled (586 with HBV and 115 with HCV). In cross-sectional analysis, both forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) decreased significantly only in smokers (smoking cases vs. smoking controls) (adjusted p = 6.6 × 10−5 and adjusted p = 2.2 × 10−3, respectively). In longitudinal analysis, smoking cases showed significantly greater FEV1 and FVC decline rates than did smoking controls (adjusted p = 8.5 × 10−3 and adjusted p = 1.2 × 10−5, respectively). Such associations were particularly high in smoking cases at intermediate-to-high risk of hepatic fibrosis, as evaluated by the non-invasive Fibrosis-4 index. In summary, CVH was associated with both decreased lung function and accelerated lung function decline in smokers. A non-invasive measurement of hepatic fibrosis may be useful in predicting rapid lung function decline in smokers with CVH.

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Abbreviations

ALT:

Alanine aminotransferase

AST:

Aspartate aminotransferase

BMI:

Body mass index

COPD:

Chronic obstructive pulmonary disease

CVH:

Chronic viral hepatitis

FEV1:

Forced expiratory volume in 1 s

FIB-4:

Fibrosis-4 index

FVC:

Forced vital capacity

HBV:

Hepatitis B virus

HBsAg:

HBV surface antigen

HCV:

Hepatitis C virus

IQR:

Interquartile range

S/CO ratio:

Signal-to-cutoff ratio

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Funding

No funding was received for conducting this study.

Author information

Author notes

  1. Suh-Young Lee and Sun-Sin Kim have contributed equally to this work.

Authors and Affiliations

  1. Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea

    Suh-Young Lee, Sun-Sin Kim, So-Hee Lee & Heung-Woo Park

  2. Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea

    Sun-Sin Kim & So-Hee Lee

  3. Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Republic of Korea

    Heung-Woo Park

  4. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea

    Heung-Woo Park

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Contributions

S-YL, S-SK, and H-WP helped in study conception and design and statistical analysis. S-SK and S-HL acquired the data. All authors analyzed and interpreted the data and critically revised the manuscript. S-YL and S–SK drafted the manuscript.

Corresponding author

Correspondence to Heung-Woo Park.

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All authors declared that none have conflict of interest related to this article.

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The study protocol was approved and the need for informed consent waived by the Institutional Review Board of Seoul National University Hospital (Approval No. H-1601–080-734).

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Lee, SY., Kim, SS., Lee, SH. et al. Chronic viral hepatitis accelerates lung function decline in smokers. Clin Exp Med 23, 2159–2165 (2023). https://doi.org/10.1007/s10238-022-00963-5

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  • DOI: https://doi.org/10.1007/s10238-022-00963-5

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