Estrogen receptor alpha gene polymorphisms and risk of HBV-related acute liver failure in the Chinese population

A total of 1216 unrelated Han Chinese HBV carriers were recruited in this hospital-based case–control study, including 359 HBV surface antigen (HBsAg) carriers affected with ALF and 857 asymptomatic HBsAg carriers. Two ESR1 haplotype tagging polymorphisms, c.30？T？>？C (rs2077647) and c.453-397？T？>？C (rs2234693), were genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay.We observed a significantly increased susceptibility to HBV-ALF associated with the c.30？C allele (P？=？8.65？×？10-4), c.453-397？C allele (5.37？×？10-4) and [c.30？C; c.453-397？C] haplotype (Dominant model, P =0.0004, odds ratio？=？1.53, 95% CI 1.23？~？1.96) compared with the T alleles and [c.30？T; c.453-397？T] haplotype of c.30？T？>？C and c.453-397？T？>？C polymorphisms, respectively.Our study suggests that [c.30？C; c.453-397？C] hapotype may be a risk factor for genetic susceptibility to HBV-related ALF in the Chinese population. It also emphasizes the importance of ESR1 in the pathophysiology of HBV-related ALF on the population level.