Relative risks of death due to liver disease among Japanese male adults having various statuses for hepatitis B s and e antigen/antibody in serum: A prospective study

Authors

  • Koshi Sakuma,

    1. Central Health Institute of Japan National Railways, Tokyo
    2. Immunology Division, Jichi Medical College, Kawachi-gun, Tochigi Prefecture
    3. Tokyo Metropolitan Institute of Medical Sciences
    4. Institute of Statistical Mathematics, Tokyo
    5. Institute of Immunology Co., Ltd., Tokyo, Railway Technical Research Institute, Tokyo
    6. Department of Medicine, Chiba University School of Medicine, Chiba, Japan
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  • Nobuteru Saitoh,

    1. Central Health Institute of Japan National Railways, Tokyo
    2. Immunology Division, Jichi Medical College, Kawachi-gun, Tochigi Prefecture
    3. Tokyo Metropolitan Institute of Medical Sciences
    4. Institute of Statistical Mathematics, Tokyo
    5. Institute of Immunology Co., Ltd., Tokyo, Railway Technical Research Institute, Tokyo
    6. Department of Medicine, Chiba University School of Medicine, Chiba, Japan
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  • Misako Kasai,

    1. Central Health Institute of Japan National Railways, Tokyo
    2. Immunology Division, Jichi Medical College, Kawachi-gun, Tochigi Prefecture
    3. Tokyo Metropolitan Institute of Medical Sciences
    4. Institute of Statistical Mathematics, Tokyo
    5. Institute of Immunology Co., Ltd., Tokyo, Railway Technical Research Institute, Tokyo
    6. Department of Medicine, Chiba University School of Medicine, Chiba, Japan
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  • Hiroshi Jitsukawa,

    1. Central Health Institute of Japan National Railways, Tokyo
    2. Immunology Division, Jichi Medical College, Kawachi-gun, Tochigi Prefecture
    3. Tokyo Metropolitan Institute of Medical Sciences
    4. Institute of Statistical Mathematics, Tokyo
    5. Institute of Immunology Co., Ltd., Tokyo, Railway Technical Research Institute, Tokyo
    6. Department of Medicine, Chiba University School of Medicine, Chiba, Japan
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  • Izumi Yoshino,

    1. Central Health Institute of Japan National Railways, Tokyo
    2. Immunology Division, Jichi Medical College, Kawachi-gun, Tochigi Prefecture
    3. Tokyo Metropolitan Institute of Medical Sciences
    4. Institute of Statistical Mathematics, Tokyo
    5. Institute of Immunology Co., Ltd., Tokyo, Railway Technical Research Institute, Tokyo
    6. Department of Medicine, Chiba University School of Medicine, Chiba, Japan
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  • Momoko Yamaguchi,

    1. Central Health Institute of Japan National Railways, Tokyo
    2. Immunology Division, Jichi Medical College, Kawachi-gun, Tochigi Prefecture
    3. Tokyo Metropolitan Institute of Medical Sciences
    4. Institute of Statistical Mathematics, Tokyo
    5. Institute of Immunology Co., Ltd., Tokyo, Railway Technical Research Institute, Tokyo
    6. Department of Medicine, Chiba University School of Medicine, Chiba, Japan
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  • Kouichi Nobutomo,

    1. Central Health Institute of Japan National Railways, Tokyo
    2. Immunology Division, Jichi Medical College, Kawachi-gun, Tochigi Prefecture
    3. Tokyo Metropolitan Institute of Medical Sciences
    4. Institute of Statistical Mathematics, Tokyo
    5. Institute of Immunology Co., Ltd., Tokyo, Railway Technical Research Institute, Tokyo
    6. Department of Medicine, Chiba University School of Medicine, Chiba, Japan
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  • Makoto Yamumi,

    1. Central Health Institute of Japan National Railways, Tokyo
    2. Immunology Division, Jichi Medical College, Kawachi-gun, Tochigi Prefecture
    3. Tokyo Metropolitan Institute of Medical Sciences
    4. Institute of Statistical Mathematics, Tokyo
    5. Institute of Immunology Co., Ltd., Tokyo, Railway Technical Research Institute, Tokyo
    6. Department of Medicine, Chiba University School of Medicine, Chiba, Japan
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  • Fumio Tsuda,

    1. Central Health Institute of Japan National Railways, Tokyo
    2. Immunology Division, Jichi Medical College, Kawachi-gun, Tochigi Prefecture
    3. Tokyo Metropolitan Institute of Medical Sciences
    4. Institute of Statistical Mathematics, Tokyo
    5. Institute of Immunology Co., Ltd., Tokyo, Railway Technical Research Institute, Tokyo
    6. Department of Medicine, Chiba University School of Medicine, Chiba, Japan
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  • Tsutomu Komazawa,

    1. Central Health Institute of Japan National Railways, Tokyo
    2. Immunology Division, Jichi Medical College, Kawachi-gun, Tochigi Prefecture
    3. Tokyo Metropolitan Institute of Medical Sciences
    4. Institute of Statistical Mathematics, Tokyo
    5. Institute of Immunology Co., Ltd., Tokyo, Railway Technical Research Institute, Tokyo
    6. Department of Medicine, Chiba University School of Medicine, Chiba, Japan
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  • Tetsuo Nakamura,

    1. Central Health Institute of Japan National Railways, Tokyo
    2. Immunology Division, Jichi Medical College, Kawachi-gun, Tochigi Prefecture
    3. Tokyo Metropolitan Institute of Medical Sciences
    4. Institute of Statistical Mathematics, Tokyo
    5. Institute of Immunology Co., Ltd., Tokyo, Railway Technical Research Institute, Tokyo
    6. Department of Medicine, Chiba University School of Medicine, Chiba, Japan
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  • Yasuo Yoshida,

    1. Central Health Institute of Japan National Railways, Tokyo
    2. Immunology Division, Jichi Medical College, Kawachi-gun, Tochigi Prefecture
    3. Tokyo Metropolitan Institute of Medical Sciences
    4. Institute of Statistical Mathematics, Tokyo
    5. Institute of Immunology Co., Ltd., Tokyo, Railway Technical Research Institute, Tokyo
    6. Department of Medicine, Chiba University School of Medicine, Chiba, Japan
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  • Kunio Okuda M.D., Ph.D.

    Corresponding author
    1. Central Health Institute of Japan National Railways, Tokyo
    2. Immunology Division, Jichi Medical College, Kawachi-gun, Tochigi Prefecture
    3. Tokyo Metropolitan Institute of Medical Sciences
    4. Institute of Statistical Mathematics, Tokyo
    5. Institute of Immunology Co., Ltd., Tokyo, Railway Technical Research Institute, Tokyo
    6. Department of Medicine, Chiba University School of Medicine, Chiba, Japan
    • First Department of Medicine, Chiba University Hospital, Chiba, Japan 280
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  • Name changed to East Japan Railway Co., April 1, 1987.

Abstract

Taking advantage of the compulsory annual medical check-up at the Central Institute of Health, Japan National Railways, hepatitis B seromarkers were tested in male employees at work and their “dead and alive” status was followed for more than 6 years for their prognostic significance. Two prospective studies were carried out. In the first study, two groups (cohorts) of males age 40 to 55 years were tested in 1973 and 1978, respectively, for HBsAg and anti-HBs. The relative risk of dying from primary liver cancer in HBsAg-positive carriers (n = 126) as compared to the controls who were negative for both HBsAg and anti-HBs (n = 5,322) was 30.03 and significantly high, whereas those positive for anti-HBs (n = 1,470) had no increased risk of dying from primary liver cancer or from other liver diseases. The follow-up period ranged from 6.5 to 11.5 years, averaging 8.5 years.

In the second study, three male cohorts of the same ages were tested for HBsAg and HBeAg/anti-HBe (micro-Ouchterlony method) in 1977, 1978 and 1979, respectively. There were 513 HBsAg-positive carriers among 25,547 examinees, who were followed for an average of 7.3 (6 to 8) years. Among these HBsAg carriers, those who were positive for HBeAg on entry had the highest risk of dying from primary liver cancer (relative risk, 50.25) and from other liver diseases (78.06), followed by those negative for both (28.95 and 21.78, respectively) and those positive for anti-HBe (9.47 and 6.43) when compared with 25,034 noncarriers. There was no significant increase in the risk of dying from nonhepatic diseases among these three e-oriented carrier groups.

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