Evidence map›Paper›PMID 41815378›Full record

ArticleInternational journal of cardiology. Cardiovascular risk and prevention2026

Paradox of hepatitis B: Metabolic risk and cardiovascular protection in a national cohort.

Wei-Lun Chen, Chien-Hao Huang, Shang-Hung Chang, Hui-Tzu Tu, Chun-Wen Cheng, Chun-Li Wang, Michael Wu, Yu-Sheng Lin, Shao-Wei Chen, Pao-Hsien Chu and 1 more

Abstract read
In one paragraph

Article in International journal of cardiology. Cardiovascular risk and prevention, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Lower MACE but higher mortality in chronic hepatitis B infection: A competing risk explanation?International journal of cardiology. Cardiovascular risk and prevention · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Wei-Lun ChenDivision of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan.
Chien-Hao HuangCollege of Medicine, Chang Gung University, Taoyuan, Taiwan.
Shang-Hung ChangDivision of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan.
Hui-Tzu TuCenter for Big Data Analytics and Statistics, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan.
Chun-Wen ChengDepartment of Infectious Diseases, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan.
Chun-Li WangDivision of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan.
Michael WuDivision of Cardiovascular Medicine, Rhode Island Hospital, Warren Alpert School of Medicine, Brown University, Providence, USA.
Yu-Sheng LinDepartment of Cardiology, Chang Gung Memorial Hospital, Chiayi, Taiwan.
Shao-Wei ChenCollege of Medicine, Chang Gung University, Taoyuan, Taiwan.
Pao-Hsien ChuDivision of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan.
Victor Chien-Chia WuDivision of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Although Hepatitis B virus (HBV) is primarily associated with hepatic complications, its link to systemic metabolic and cardiovascular diseases remains inconclusive. This study investigated the paradoxical relationship between HBV infection and cardiovascular outcomes in a large nationwide cohort. Methods: A retrospective cohort study was conducted using the Taiwan National Health Insurance Research Database (2010-2020). After strict exclusion and two-step propensity score matching, 409,799 HBV-infected patients and 2,048,995 matched controls were identified. We analyzed the incidence of metabolic disorders, major adverse cardiovascular events (MACE), and all-cause mortality. Results: HBV infection was associated with increased risks of diabetes (HR: 1.10), hypertension (HR: 1.17), and hyperlipidemia (HR: 1.18). Paradoxically, HBV patients exhibited significantly lower risks of coronary artery disease (HR: 0.88), acute myocardial infarction (HR: 0.61), ischemic stroke (HR: 0.70), and cardiovascular death (HR: 0.58). Despite this cardiovascular protection, all-cause mortality was markedly higher in the HBV group (HR: 2.31). Conclusions: Chronic HBV infection presents a distinct clinical paradox: increased metabolic risk but reduced cardiovascular events. These findings suggest complex immune-metabolic interactions. Clinical management should address both the hepatic burden and the elevated metabolic risks, despite the apparent cardiovascular protection.

Indexed as

Cardiovascular outcomesHepatitis B virusMajor adverse cardiovascular eventsMetabolic disordersNationwide cohort

Identifiers

PMID41815378
PMCPMC12973526

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.