Mortality after chronic hepatitis B virus infection: A linkage study involving 2 million parous women from Taiwan

Chyng Wen Fwu, Yin Chu Chien, Kenrad E. Nelson, Gregory D. Kirk, San Lin You, Hsu Sung Kuo, Manning Feinleib, Chien Jen Chen

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


Background. Few studies have evaluated survival rates among women who have chronic hepatitis B virus infection. We investigated the overall and disease-specific mortality rates in a nationwide cohort of women after they were screened for hepatitis B surface antigen (HBsAg) during pregnancy. Methods. HBsAg prenatal screening data were available for 2,087,994 women in Taiwan between 1 January 1986 and 31 March 2000 in the National Hepatitis B Vaccination Registry. Their vital status and cause of death were ascertained by computerized linkage with the National Death Certification Registry. Cox proportional hazards models were used to estimate the association between HBsAg status and specific causes of death. Results. Overall, 14,524 deaths were identified after a mean of 11.43 years of follow-up. The age-adjusted hazard ratio for mortality among HBsAg carriers compared with noncarriers was 1.24 (95% confidence interval [CI], 1.19-1.30), 6.59 (95% CI, 5.70-7.61), and 1.09 (95% CI, 1.04-1.14) for all-cause, liver-specific, and nonliver-related deaths, respectively. In addition to liver-specific causes, a significantly increased risk of mortality from non-Hodgkin lymphoma (P<.001) and gallbladder and extrahepatic bile duct cancer (P = .01) was observed. Conclusions. Our study found an excess risk of death due to both liver-specific and non-liver-related causes for HBsAg-positive women in Taiwan. Effective prevention and treatment of hepatitis B virus infection is an important public health priority.

Original languageEnglish (US)
Pages (from-to)1016-1023
Number of pages8
JournalJournal of Infectious Diseases
Issue number7
StatePublished - Apr 1 2010

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases


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