Abstract
To assess whether hepatitis C virus infection was a risk factor for the development of non‐alcoholic liver cirrhosis, antibody to hepatitis C virus (anti‐HCV; detected by a second generation HCV enzyme immunoassay), hepatitis B surface antigen (HBsAg; detected by radioimmunoassay) were tested in 150 cirrhotics and 150 sex‐matched and age‐matched healthy controls. The prevalence of anti‐HCV and HBsAg in cirrhotics was higher than in controls (22.0%, 73.3% vs. 2%, 18.7%; P = 0.001). The prevalence of anti‐HCV in HBsAgnegative cirrhotics (45.0%) was higher than that in HBsAg‐positive patients (13.6%; P =0.001). Both the anti‐HCV and carriage of HBsAg were associated significantly with liver cirrhosis, showing odds ratio of 12.0 for HBsAg carriers and 13.8 for patients with anti‐HCV. Compared with those without HBsAg and anti‐HCV, there was a significantly positive linear trend for developing cirrhosis with the presence of HBsAg alone (odds ratio = 19.9), anti‐HCV alone (odds ratio = 49.0), and those positive for HBsAg and anti‐HCV (odds ratio = 81.8) (P = 0.00001). The population‐attributable risk for developing liver cirrhosis was estimated as 10.8% for anti‐HCV alone, 55.2% for HBsAg alone, and 9.4% for both anti‐HCV and HBsAg in southern Taiwan. In conclusion, this study shows that hepatitis B and C virus infection act independently and synergistically in the development of non‐alcoholic liver cirrhosis among Chinese in Taiwan.