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While previous research has established a connection between heavy metals and liver function biomarkers, the specific relationship between heavy metals and HBV infection remains unexplored. This cross-sectional study aims to investigate the potential correlations between five blood heavy metals - lead, cadmium, mercury, manganese, and selenium - and the presence of HBsAg, HBsAb, and HBcAb in adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study utilized data from NHANES 2007\u20132018. Participants were classified into four groups based on their infectious status, and the association between heavy metals and HBV infection was analyzed using multiple logistic regression and stratification analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 8431 participants were included, with 5 436 classified as Susceptible, 1 765 as Vaccinated, 865 as Natural Infection, and 103 as Acute\/Chronic HBV Infection. The Vaccinated group exhibited a lower mean age (34.52\u2009\u00b1\u200914.16 years) compared to the other groups. Statistically significant differences in heavy metal concentrations (except selenium) were observed among the groups (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). After adjusting for covariates, lead was significantly associated with HBV infection (Q2: OR 2.37, 95%CI 1.04\u20135.39; Q3: OR 2.34, 95%CI 1.01\u20135.40), and positive trends were observed for high blood concentrations of mercury (Q4: OR 3.03, 95%CI 1.31\u20137.04) and manganese (Q4: OR 2.52, 95%CI 1.20\u20135.28). Furtherly, the presence of lead reduced the protection of HBsAb (Q2: OR 0.84, 95%CI 0.73\u20130.97; Q3: OR 0.77, 95%CI 0.66\u20130.90; Q4: OR 0.83, 95%CI 0.70\u20130.98). Subgroup analysis indicated that cadmium was associated with an increased risk of HBV infection in Asians (OR 1.36, 95%CI 1.03\u20131.78) and individuals with a BMI range of 25 to 30 (OR 1.60, 95%CI 1.17\u20132.18).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The study\u2019s findings suggest a correlation between elevated blood Pb concentrations and reduced immunization rates against hepatitis B. Individuals with a positive HBsAg exhibit lower blood Se concentrations and higher blood Hg and Mn concentrations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12889-024-17799-1","type":"journal-article","created":{"date-parts":[[2024,1,23]],"date-time":"2024-01-23T06:02:17Z","timestamp":1705989737000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Associations of five blood heavy metals with hepatitis B virus infection and immunity in adults: a cross-sectional study"],"prefix":"10.1186","volume":"24","author":[{"given":"Xinpeng","family":"Li","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Bi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lu","family":"Han","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,1,23]]},"reference":[{"issue":"9959","key":"17799_CR1","doi-asserted-by":"publisher","first-page":"2053","DOI":"10.1016\/S0140-6736(14)60220-8","volume":"384","author":"C Trepo","year":"2014","unstructured":"Trepo C, Chan HL, Lok A. 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