Association Between Hepatitis B Virus Infection and Chronic Kidney Disease in University Students Receiving Physical Check-ups: A Cross-sectional Study

Objective: Chronic kidney disease (CKD) is prevalent in Taiwan, a country in which hepatitis B virus (HBV) is endemic. The relationship between HBV and CKD remains unclear with inconsistent evidence.This cross-sectional study was intended to investigate the association between HBV and CKD among university freshmen in Taiwan. Methods: In this study, we analyzed the data obtained from routine medical examinations of 7,745 entrant students at a university in northern Taiwan. The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation was used to calculate the estimated glomerular filtration rate (eGFR). The odds ratios (ORs) and 95% confidence intervals (CIs) for the association between HBV and CKD were estimated using logistic regression. Results: In the study participants, the prevalence of HBV and CKD was 7.4% and 13.5%, respectively. The presence of HBV did not differ significantly between patients with CKD and the comparison group (7.6% vs. 7.3%). After adjusting for covariates, logistic regression analyses for the association between HBV and CKD and for the association between HBV and low eGFR (less than 60mL/min per 1.73m²) yielded ORs of 1.11 (95% CI, 0.86-1.43) and 1.10 (95% CI, 0.77-1.58), respectively. Stratification by sex showed no significant difference for low eGFR. However, the association between HBV infection and the risk of CKD was positive for men (OR=1.53, 95% CI=1.00-2.32) and negative for women (OR=0.95, 95% CI=0.69-1.30) (sex-HBV interaction test). Conclusion: Our findings did not support the hypothesis that HBV infection is associated with an increased risk of CKD. Young men with HBV infection tend to have less protection against CKD. However, the possible differences between the sexes for the risk of CKD require clarification in further studies using larger samples.