Hepatitis B and C infections and risk of age related macular degeneration in a nationwide Korean cohort

Abstract Evidence on viral hepatitis and age-related macular degeneration (AMD) remains limited, particularly from long-term prospective studies. We investigated whether hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are associated with the subsequent development of AMD in a nationwide Korean cohort. Using National Health Insurance Service data, we included 12,386,563 adults aged ≥ 40 years who underwent health examinations in 2009–2010 and were followed through 2023. HBV and HCV infections were identified using diagnostic codes. Incident AMD was classified as exudative using Rare Intractable Disease registration codes and as nonexudative using Korean Classification of Diseases codes. During follow-up, 388,652 participants developed incident AMD. In multivariable Cox proportional hazards models, HBV infection was associated with increased risks of exudative AMD (hazard ratio [HR] 1.18, 95% confidence interval [CI] 1.05–1.32) and nonexudative AMD (HR 1.68, 95% CI 1.60–1.76). HCV infection was also associated with increased risks of exudative AMD (HR 1.53, 95% CI 1.27–1.86) and nonexudative AMD (HR 1.41, 95% CI 1.27–1.57). Associations appeared stronger in women in sex-stratified analyses. HBV and HCV infections were associated with increased risks of both exudative and nonexudative AMD.