Association of ERα gene polymorphism at position 29 with HBV-related acute-on-chronic liver failure

Objective To investigate the relationship between estrogen receptor alpha ( ERα) gene polymorphism at position 29 and hepatitis B virus ( HBV) -related acute-on-chronic liver failure ( HBV-ACLF) and the genetic pathogenesis of HBV-ACLF. Methods A total of 61HBV-ACLF patients, 79 patients with chronic hepatitis B ( CHB) , and 69 patients who automatically recovered from HBV infection were included in the study. The ERα gene polymorphism at position 29 was analyzed by polymerase chain reaction-restriction fragment length polymorphism. The allele frequency was calculated by gene counting, and Hardy-Weinberg equilibrium test was performed. Confounding factors were adjusted by unconditional logistic regression analysis. Comparisons of genotype frequency and allele frequency were made by chi-square test ( R × C) . Results The frequencies of TT genotype and T allele of ERα gene at position 29 were significantly higher in HBV-ACLF patients than in CHB patients (55.7% vs 31.6%, χ2=8. 194, P =0. 004; 77. 1% vs 54. 4%, χ2=15. 341, P <0. 001) , and the risk of worsening in HBV infection patients with T allele was 2. 811 times that in HBV infection patient with C allele ( OR =2. 811, 95% CI: 1. 662-4. 753) . The frequencies of TT genotype and T allele of ERα gene at position 29 were significantly higher in HBV-ACLF patients than in patients who recovered from HBV infection ( 55. 7% vs11. 6%, χ2=28. 849, P <0. 001; 77. 1% vs 32. 6%, χ2=51. 401, P <0. 001) , and the risk of worsening in HBV infection patients with T allele was 6. 938 times that in patients with C allele ( OR =6. 938, 95% CI: 3. 995-12. 050) . Conclusion TT genotype and T allele of ERα gene at position 29 might be the susceptibility gene for HBV-ACLF.