Chronic viral hepatitis accelerates lung function decline in smokers

• Published in: Clinical and experimental medicine 2023-10, Vol.23 (6), p.2159-2165
• Main Authors: Lee, Suh-Young, Kim, Sun-Sin, Lee, So-Hee, Park, Heung-Woo
• Format: Article
• Language: English
• Subjects: Body mass index; Chronic infection; Fibrosis; Hematology; Hepatitis B; Hepatitis B surface antigen; Hepatitis C; Internal Medicine; Liver; Lung diseases; Medicine; Medicine & Public Health; Oncology; Respiratory function; Smoking; Viruses
• ISSN: 1591-9528; 1591-8890; 1591-9528
• DOI: 10.1007/s10238-022-00963-5

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.