Hepatitis B virus and the risk of coronary heart disease: A comprehensive systematic review and meta-analyses of observational studies

Abstract Background Several studies have reported that hepatitis B virus (HBV) infection affects the risk of coronary heart disease. However, its association is controversial. Thus, we conducted a systematic review and meta-analysis to better understand it. Methods Relevant studies published before October 2017 were identified by searching PubMed, EMBASE, and ISI Web of Science. The relationships between HBV and the risk of coronary heart disease were assessed using Relative risk (RR) values and the corresponding 95% confidence intervals (CIs). We used the random effects model proposed by DerSimonian and Laird to quantify the relationship. Results Nine articles, including 65,058 HBV-infected patients and 534,998 uninfected controls, were included in the meta-analysis. The present study does not support that HBV infection is associated with the risk of coronary heart disease (RR = 0.99, CI = 0.76–1.22; I 2  = 68.9%). Sensitivity analysis and ‘trim and fill' method yielded similar results. No evidence of publication bias was observed. Conclusions HBV infection does not increase the risk of coronary heart disease. The associations were not significant both in cohort studies and in case-control studies.