Diverse effects of hepatic steatosis on fibrosis progression and functional cure in virologically quiescent chronic hepatitis B.

Like Comment
Concomitant non-alcoholic fatty liver disease is common in patients with chronic hepatitis B (CHB) infection, although its impact on liver-related outcomes remains controversial. We aimed to study the effect of hepatic steatosis on risk of fibrosis progression and hepatitis B surface antigen (HBsAg) seroclearance.Treatment-naive CHB patients with normal alanine aminotransferase and low viremia (serum HBV DNA <2000 IU/mL) were prospectively recruited for baseline and 3-year transient elastography assessment. Fibrosis staging was defined according to the EASL-ALEH guidelines, with fibrosis progression defined as ≥1 stage increment of fibrosis. Hepatic steatosis and severe hepatic steatosis were defined as controlled attenuation parameter (CAP) ≥248 dB/m & ≥280 dB/m respectively.330 patients (median age 50.5 years, 41.2% male, median HBV DNA 189 IU/mL) were recruited. Twenty-two patients (6.7%) achieved HBsAg seroclearance during follow-up, and the presence of hepatic steatosis was associated with significantly higher chance of HBsAg seroclearance (hazard ratio: 3.246, 95%CI 1.278-8.243, p=0.013). At baseline, 48.8% and 28.8% had steatosis and severe steatosis, respectively. 4.2% had F3/F4 at baseline, which increased to 8.7% at 3 years. The rate of liver fibrosis progression in patients with persistent severe steatosis was higher than those without steatosis (41.3% vs. 23%, p=0.05). Persistent severe hepatic steatosis was independently associated with fibrosis progression (odds ratio: 2.379, 95%CI 1.231-4.597, p=0.01).CAP measurements have predictive values in virologically quiescent CHB patients. Presence of hepatic steatosis was associated with a higher risk of fibrosis progression but paradoxically a 3-fold increase in HBsAg seroclearance rate.


Click here to read the full article @ Journal of Hepatology
Go to the profile of ClinOwl

ClinOwl

The wider, wiser view for healthcare professionals. ClinOwl signposts the latest clinical content from over 100 leading medical journals.
1898 Contributions
1 Followers
0 Following

No comments yet.