Association between hepatitis B surface antibody seropositivity and coronary artery disease

Background : Specific infectious agents have been found to be related to the pathogenesis of coronary atherosclerosis.
Aims : We assessed the possible association between angiographically proven coronary artery disease (CAD) and hepatitis B surface antibody (HBS Ab) seropositivity in a population with relatively high prevalence of hepatitis B virus (HBV) infection.
Setting and Design : This was a cross-sectional study.
Materials and Methods : We analyzed data from 830 consecutive subjects undergoing coronary angiography, including angiographic results reported by two cardiologists for inter-observer reliability and assessment of HBS Ab status determined by enzyme-linked immunosorbent assay (ELISA).
Statistical Analysis Used : Chi-square test or Fisher′s exact test, independent two-sample t test and the Pearson′s Correlation Coefficient test were used, as required. Statistics were performed using SPSS software version 13 (SPSS, Chicago, IL).
Results : Two hundred forty-nine (30%) subjects had normal angiogram or minimal CAD, and 581 (70%) had significant CAD in at least one major coronary artery. In patients with CAD and in patients without angiographic evidence of significant atherosclerosis, 28.7% and 28.9% respectively were positive for HBV (P = 0.954). Mean C-reactive protein levels in subjects with positive and negative HBS Ab were 10.77 ± 8.37 mg/L versus 10.33 ± 7.64 mg/L respectively (P = 0.465). However, C-reactive protein levels in CAD group were significantly higher (P < 0.001).
Conclusions : Our results suggested hepatitis B surface antibody seropositivity has no relationship with coronary artery disease. Moreover, no significant linear correlation exists between HBS Ab and C-reactive protein levels. However, as previously shown, C-reactive protein level in patients with coronary artery disease is significantly higher than in patients with normal coronary arteries.

Keywords
C-reactive protein, coronary artery disease, hepatitis B surface antibody, infection, inflammation