HBV infection, liver enzymes and their association with adverse liver disease and all-cause death: a matched retrospective cohort study in Eastern China.

HBV infection is associated with an increasing trend of cirrhosis and other chronic liver diseases in low and low-middle sociodemographic index (SDI) regions, and a rise in liver cancer in high SDI regions. 28 Specific causal pathways involving adiposity, depression, glucose metabolism and lipid levels have been identified as mediators linking educational attainment and chronic hepatitis. 29 30 Populations with low education levels are at high risk for adverse liver diseases, highlighting the need to strengthen hepatitis B treatment, disease management and liver cancer screening in this group.

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