Ischemic Heart Disease in Chronic Hepatitis B: A Danish Nationwide Cohort Study

Abstract

Objective

Data on the risk of ischemic heart disease (IHD) in patients with chronic hepatitis B virus (CHB) are conflicting. Our objective was to address the rate of IHD in patients with CHB compared with individuals without CHB (control-persons) from the general population.

Study Design and Setting

We conducted a cohort study of prospectively obtained data from Danish nationwide registries. We produced cumulative incidence curves and calculated the unadjusted incidence rate ratio (IRR) of IHD in persons with and without CHB. The adjusted association between having CHB and developing IHD was examined using a cause-specific Cox regression model.

Results

In total, 6472 persons with CHB and 62,251 age- and sex-matched individuals from the general population were followed for 48,840 and 567,456 person-years, respectively, during which 103 (1,59%) with CHB and 1058 (1,70%) control-persons developed IHD. The crude IRR was 1.13 (95% CI: 0.91–1.39). CHB did not have a statistically significant effect on the rate of IHD after adjusting for several confounding factors (adjusted hazard ratio: 0.96, 95% CI: 0.76–1.21).

Conclusion

In this nationwide cohort study, we did not find any difference between rate of IHD in persons with CHB in comparison with the general population.

Keywords:

• hepatitis B virus
• viral infection
• atherosclerosis
• coronary heart disease
• ischemic heart disease
• cardiovascular disease
• general population

Data Sharing Statement

Data used in the present study cannot be shared due to Danish data protection rules and regulations.

Ethics Statement

The study has been approved by the Danish Data Protection Agency (j.nr. P-2019-829) as required by Danish Law. No further approvals were required.

Acknowledgments

We extend our gratitude to all the patients who participated in the DANHEP cohort study.

Disclosure

NW has been a clinical investigator, lecturer or member of advisory boards for AbbVie, GSK, MSD. Gilead and has received unrestricted grants for research from AbbVie and Gilead, with no relation to the present work. PBC has received unrestricted grants for research from AbbVie, Gilead, and MSD, not related to this study. FE reports personal fees from MSD, during the conduct of the study. The authors report no other conflicts of interest in this work.

Additional information

Funding

Signe Bollerup has received funding from Manufacturer Vilhelm Pedersen and Wife’s Foundation; Free research funds of University Hospital of Copenhagen, Amager and Hvidovre; Grant in memory of Carpenter Jørgen Holm and wife Elisa B. Hansen (1906–1948); Aase and Ejnar Danielsens Foundation and Scandinavian Society for Antimicrobial Chemotherapy Foundation (SLS-935536).