Background

Arsenic alters immunological parameters including antibody formation and antigen-driven T-cell proliferation.

Objective

We evaluated the cross-sectional relationship between urinary arsenic and the seroprevalence of hepatitis B (HBV) infection in the United States using data from six pooled cycles of the National Health and Nutrition Examination Survey (2003–2014, N = 12,447).

Methods

Using serological data, participants were classified as susceptible, immune due to vaccination, or immune due to past natural infection. We used multinomial logistic regression to evaluate the association between urinary DMA and HBV classification. A sensitivity analysis using total urinary arsenic (TUA) was also conducted. Both DMA and TUA were adjusted for arsenobetaine using a residual regression method

Results

A 1-unit increase in the natural logarithm (ln) of DMA was associated with 40% greater adjusted odds of having immunity due to natural infection compared to being susceptible (Odds Ratio [aOR]: 1.40, 95% Confidence Intervals [CI] 1.15, 1.69), 65% greater odds of having immunity due to a natural infection (aOR: 1.65, 95% CI: 1.34, 2.04) and 18% greater odds of being susceptible (aOR: 1.18, 95% CI: 1.05, 1.33) compared to being immune due to vaccination after adjusting for creatinine, age, sex, race, income, country of birth, BMI, survey cycle, serum cotinine, recent seafood intake, and self-reported HBV immunization status.

Conclusion

In the U.S. general public, higher urinary arsenic levels were associated with a greater odds of having a serological classification consistent with a past natural hepatitis B infection after adjusting for other risk factors. Additionally, higher urinary arsenic levels were linked to a greater odds of not receiving hepatitis B vaccinations. Given the cross-sectional nature of this analysis, more research is needed to test the hypothesis that environmentally relevant exposure to arsenic modulates host susceptibility to hepatitis B virus.

中文翻译：

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美国砷和乙型肝炎感染血清阳性率的横断面关联（NHANES 2003-2014）

背景

砷会改变免疫学参数，包括抗体形成和抗原驱动的 T 细胞增殖。

客观的

我们使用来自国家健康和营养检查调查（2003-2014 年，N = 12,447）的六个汇总周期的数据评估了尿砷与美国乙型肝炎 (HBV) 感染血清流行率之间的横截面关系。

方法

使用血清学数据，参与者被分类为易感、因疫苗接种而免疫或因过去自然感染而免疫。我们使用多项逻辑回归来评估尿 DMA 与 HBV 分类之间的关联。还进行了使用总尿砷 (TUA) 的敏感性分析。DMA 和 TUA 均使用残差回归法针对砷甜菜碱进行了调整

结果

与易感者相比，DMA 的自然对数 (ln) 增加 1 个单位与因自然感染而产生免疫力的调整后的几率增加 40% 相关（优势比 [aOR]：1.40，95% 置信区间 [CI] 1.15 , 1.69), 由于自然感染而产生免疫力的几率增加 65% (aOR: 1.65, 95% CI: 1.34, 2.04) 和易感几率增加 18% (aOR: 1.18, 95% CI: 1.05, 1.33)与在调整肌酐、年龄、性别、种族、收入、出生国家、BMI、调查周期、血清可替宁、最近的海鲜摄入量和自我报告的 HBV 免疫状态后因接种疫苗而获得免疫相比。

结论

在美国公众中，在调整其他风险因素后，较高的尿砷水平与血清​​学分类与过去自然乙型肝炎感染一致的可能性更大。此外，较高的尿砷水平与较高的未接种乙型肝炎疫苗的几率有关。鉴于该分析的横截面性质，需要更多的研究来检验与环境相关的砷暴露会调节宿主对乙型肝炎病毒的易感性的假设。