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©The Author(s) 2023.
World J Gastroenterol. Aug 28, 2023; 29(32): 4900-4911
Published online Aug 28, 2023. doi: 10.3748/wjg.v29.i32.4900
Published online Aug 28, 2023. doi: 10.3748/wjg.v29.i32.4900
Table 1 Prevalence of hepatitis B infection in patients with Wilson disease stratified by gender and age
Number of patients | Negative for HBVM (%) | Anti-HBs(+) alone (%) | Prior HBV infection (%) | Current HBV infection (%) | |
Total group | 915 | 393 (43.0) | 419 (45.8) | 84 (9.2) | 19 (2.1) |
Sex | |||||
Male | 532 | 228 (42.9) | 239 (44.9) | 52 (9.8) | 13 (2.4) |
Female | 383 | 165 (43.1) | 180 (47.0) | 32 (8.4) | 6 (1.6) |
Age group (yr) | |||||
2-10 | 231 | 105 (45.5) | 119 (51.5) | 7 (3.0) | 0 (0.0) |
11-20 | 340 | 156 (45.9) | 159 (46.8) | 15 (4.4) | 10 (2.9) |
21-30 | 153 | 63 (41.2) | 73 (47.7) | 13 (8.5) | 4 (2.6) |
31-40 | 106 | 40 (37.7) | 42 (39.6) | 21 (19.8) | 3 (2.8) |
41-65 | 85 | 29 (34.1) | 26 (30.6) | 28 (32.9) | 2 (2.3) |
Table 2 Characteristics of patients with Wilson disease and chronic hepatitis B: The demographic characteristics and parameters of hepatitis B virus infection
Case | Sex | Age (yr) | History of HBV (yr) | HBsAg | HBeAg | Anti-HBe | HBV DNA |
1 | Female | 16 | 2 | + | - | + | < 100 |
2 | Male | 19 | 2 | + | - | + | 9.3e8 |
3 | Female | 19 | 2 | + | - | - | < 100 |
4 | Male | 26 | 3 | + | + | - | 1.9e6 |
5 | Male | 43 | 3 | + | - | + | 5.6e5 |
6 | Female | 37 | 2 | + | + | 7.3e3 | |
7 | Male | 19 | 3 | + | - | + | < 100 |
8 | Male | 11 | 5 | + | + | - | 3.2e7 |
9 | Male | 26 | 20 | + | - | + | 1.9e4 |
10 | Female | 17 | 3 | + | - | + | < 10 |
11 | Male | 20 | 10 | + | + | - | 2.3e4 |
12 | Male | 11 | ? | + | - | + | < 10 |
13 | Female | 32 | ? | + | - | + | 81 |
14 | Male | 27 | ? | + | + | - | 1.3e6 |
15 | Male | 24 | 16 | + | + | - | 2.1e8 |
16 | Male | 15 | 16 | + | - | + | < 10 |
17 | Male | 65 | 30 | + | - | + | 22.3 |
18 | Female | 35 | 16 | + | - | + | < 10 |
19 | Male | 15 | 10 | + | + | - | 1.8e6 |
Table 3 Characteristics of patients with Wilson disease and chronic hepatitis B: Diagnostic parameters of Wilson disease
Case | Neurologic signs | KF rings | Cerulo plasmin (mg/L) | Urinary copper/after PC (μg/24 h) | Hepatic copper (μg/g/dw) | Mutation analysis | WD score |
1 | No | P | 65.0 | 177/1600 | ND | ND | 5 |
2 | No | P | 50.0 | 1222/4250 | ND | ND | 6 |
3 | No | P | 95.0 | 1818/2266 | ND | ND | 6 |
4 | Yes | P | 187.0 | 434/ND | ND | ND | 7 |
5 | No | P | 172.0 | 107/1295 | 347 | ND | 6 |
6 | No | P | 216.0 | 431/1436 | 1165 | ND | 6 |
7 | No | P | 50.0 | 5171/15398 | ND | ND | 6 |
8 | No | P | 250.0 | 305/1933 | 1173 | ND | 6 |
9 | No | N | 74.0 | 474/1500 | 926 | 3532G>T/3532G>T | 10 |
10 | No | P | 84.0 | 595/1725 | ND | 2755C>G/2975C>T | 10 |
11 | No | N | 135.0 | 1297/2984 | ND | 588C>A/2333G>T | 7 |
12 | No | P | 78.4 | 160/1773 | 741 | 2975C>T/2975C>T | 11 |
13 | No | P | 129 | 855/2505 | ND | ND | 5 |
14 | No | P | 31.0 | 310/1984 | 1067 | 3809 >G/ | 9 |
15 | No | N | 104.0 | 187/1836 | 896 | 0 | 4 |
16 | Yes | P | 86.5 | 237/2374 | 404 | ND | 10 |
17 | No | P | 83.1 | 64/714 | 265 | 2975C>T/ | 7 |
18 | No | P | 43.0 | 155/171 | 906 | 2804C>T/2810delT | 11 |
19 | No | P | 63.0 | 584/2473 | ND | 2666G>T/2333G>T | 10 |
Table 4 Characteristics of patients with Wilson disease and chronic hepatitis B: Parameters of liver disease
Case | ALT | AST | ALB | TBIL | GGT | ALP | INR | Severity of liver disease | Outcome |
1 | 29 | 50 | 20.3 | 46.7 | 46 | 74 | 2.61 | CTP: 13 | Died |
2 | 70 | 185 | 26.8 | 264 | 84 | 61 | 2.8 | ACLF | Died |
3 | 86 | 50 | 25.1 | 123 | 58 | 85 | 2.7 | CTP: 13 | Died |
4 | 41 | 60 | 30.4 | 44.4 | 90 | 70 | 4.5 | CTP: 13 | Died |
5 | 102 | 170 | 35.7 | 48.0 | 110 | 95 | 1.5 | CTP: 10 | Died |
6 | 119 | 291 | 27.6 | 417 | 186 | 390 | 2.1 | ACLF | Alive |
7 | 79 | 123 | 31 | 456 | 45 | 57 | 4.1 | ACLF | Died |
8 | 231 | 237 | 37.5 | 16.5 | 353 | 105 | 1.2 | CTP:6 | Alive. |
9 | 74 | 101 | 29.8 | 39.0 | 42 | 116 | 1.5 | CTP:10 | Alive |
10 | 79 | 105 | 24.5 | 42.0 | 110 | 130 | 2.4 | CTP:12 | Alive |
11 | 223 | 268 | 30.0 | 368 | 147 | 252 | 2.8 | ACLF | Died |
12 | 71 | 83 | 31.0 | 23.0 | 62 | 357 | 1.6 | CTP:10 | Alive |
13 | 70 | 76 | 28.0 | 25.6 | 35 | 375 | 1.63 | CTP:10 | Alive |
14 | 82 | 151 | 37.8 | 28.7 | 152 | 149 | 1.36 | CTP:5 | Alive |
15 | 276 | 102 | 39.9 | 25.3 | 113 | 93 | 0.95 | Hepatitis | Alive |
16 | 22 | 47 | 36.5 | 16 | 32 | 219 | 1.25 | Hepatitis | Alive |
17 | 31 | 28 | 47.3 | 26.3 | 23 | 76 | 1.01 | Hepatitis | Alive |
18 | 56 | 34 | 42.0 | 22.0 | 90 | 60 | 1.01 | Hepatitis | Alive |
19 | 57 | 74 | 28.0 | 373 | 268 | 293 | 3.01 | ACLF | Died |
Table 5 Factors associated with severe liver disease at the Wilson disease diagnosis
Factors (at diagnosis) | OR | 95%CI | P value |
Gender | |||
Male | 1 | ||
Female | 1. 945 | 1.402-2.698 | 0.000 |
Age at diagnosis (yr) | |||
Group 1 (0-10) | 1 | ||
Group 2 (11-20) | 1.766 | 1.145-2.723 | 0.010 |
Group 3 (21-30) | 0.757 | 0.423-1.352 | 0.346 |
Group 4 (31-40) | 1.178 | 0.646-2.148 | 0.594 |
Group 5 (41-65) | 1.455 | 0.777-2.724 | 0.241 |
HBV infection | |||
WD alone | 1 | ||
WD with previous HBV | 5.255 | 3.159-8.739 | 0.000 |
WD with current HBV | 7.748 | 2.890-20.774 | 0.000 |
Table 6 Comparison of hepatitis B surface antigen positivity rates among different age groups between patients with Wilson disease and the general population
Age groups (yr) | Wilson disease | General population (Henan) | P value | ||
Number tested | HBsAg(+) (n, %) | Number tested | HBsAg(+) (n, %) | ||
1-4 | 40 | 0, 0.0 | 5474 | 26, 0.5 | 0.827 |
5-9 | 148 | 0, 0.0 | 4407 | 32, 0.7 | 0.625 |
10-14 | 191 | 3, 1.6 | 3376 | 40, 1.2 | 0.505 |
15-17 | 97 | 3, 3.1 | Not done | ||
18-34 | 298 | 9, 3.0 | 6764 | 220, 3.1 | 0.825 |
35-54 | 122 | 3, 2.5 | 6777 | 275, 4.7 | 0.490 |
55-74 | 19 | 1, 5.3 | 3144 | 147, 5.1 | 0.599 |
Total | 915 | 19, 2.1 | 29892 | 740, 2.5 | 0.510 |
Table 7 Comparison between Wilson disease patients alone and Wilson disease patients with hepatitis B virus infection
WD alone (n = 812) | With previous HBV (n = 84) | With current HBV (n = 19) | P1 | P2 | |
Sex | |||||
Male (n, %) | 467 (57.5) | 46 (61.9) | 12 (63.2) | 0.509 | 0.797 |
Female (n, %) | 345 (42.5) | 32 (38.1) | 7 (36.8) | 0.509 | 0.797 |
Mean age (yr) | 18.8 ± 12.0 | 33. ± 15.9 | 25.0 ± 13. | 0.000 | 0.031 |
Diagnosis delay | 12.1 ± 21.3 | 13.7 ± 26.1 | 34.6 ± 53.5 | 0.542 | 0.000 |
Phenotype | |||||
Pure H (n, %) | 564 (69.5) | 63 (75.0) | 17 (89.5) | 0.352 | 0.104 |
H and N (n, %) | 195 (24.40) | 21 (25.60) | 2 (10.5) | 0.352 | 0.104 |
Pure N (n, %) | 35 (4.3) | 0 (0.0) | 0 | ||
Others (n, %) | 18 (2.2) | 0 | 0 | ||
Copper metabolic | |||||
KF positive | 67.6% | 84.1% | 78.9% | 0.102 | 0.456 |
Ceruloplasmin | 64.1 ± 46.0 | 97.1 ± 60.3 | 105.0 ± 61.6 | 0.000 | 0.000 |
Urinary copper | 502.4 ± 1030.5 | 916.3 ± 245.8 | 767.7 ± 1165.0 | 0.005 | 0.323 |
Urinary Cu after PC | 2236.4 ± 1582.1 | 2283.7 ± 1287.8 | 2793.8 ± 3157.5 | 0.842 | 0.144 |
Hepatic Cu | 832.2 ± 457.7 | 680.1 ± 407.7 | 789.0 ± 338.2 | 0.191 | 0.767 |
Mean WD score | 7.4 ± 2.3 | 8.0 ± 2.2 | 7.8 ± 2.3 | 0.124 | 0.412 |
Biochemical | |||||
ALT (IU/L) | 86.2 ± 105.7 | 63.3 ± 51.0 | 94.6 ± 71.1 | 0.0051 | 0.722 |
AST (IU/L) | 84.25 ± 90.3 | 90.47 ± 70.4 | 125.3 ± 80.5 | 0.0532 | 0.058 |
Albumin (g/L) | 38.5 ± 8.3 | 32.5 ± 7.6 | 32.1 ± 6.8 | 0.000 | 0.001 |
TBIL (μmol/L) | 52.1 ± 131.0 | 104.7 ± 166.7 | 126.6 ± 158.3 | 0.001 | 0.002 |
GGT (IU/L) | 90.9 ± 85.6 | 138.6 ± 112.3 | 109 ± 93.3 | 0000 | 0.399 |
ALP (IU/L) | 186.7 ± 133.6 | 137.7 ± 87.7 | 171.9 ± 123.0 | 0.001 | 0.650 |
INR | 1.42 ± 0.81 | 1.88 ± 0.86 | 2.09 ± 1.04 | 0.000 | 0.000 |
Liver disease severity | |||||
Hepatitis (n, %) | 372 (45.8) | 7 (8.3) | 3 (15.8) | 0.000 | 0.009 |
CTP5-6 (n, %) | 189 (23.3) | 18 (21.4) | 3 (15.8) | 0.702 | 0.444 |
CTP7-9 (n, %) | 94 (11.6) | 14 (16.7) | 1 (5.3) | 0.173 | 0.713 |
CTP10-14 (n, %) | 120 (14.8) | 34 (40.5) | 7 (36.8) | 0.000 | 0.008 |
ACLF (n, %) | 37 (4.5) | 11 (13.1) | 5 (26.3) | 0.001 | 0.000 |
Mortality (n, %), | 33 (4.1) | 13 (15.5) | 7 (36.8) | 0.000 | 0.000 |
- Citation: Zhou HY, Yang X, Luo KZ, Jiang YF, Wang WL, Liang J, Li MM, Luo HY. Hepatitis B virus infection in patients with Wilson disease: A large retrospective study. World J Gastroenterol 2023; 29(32): 4900-4911
- URL: https://www.wjgnet.com/1007-9327/full/v29/i32/4900.htm
- DOI: https://dx.doi.org/10.3748/wjg.v29.i32.4900