Highlights• HBV viral load is an important predictor of adverse outcomes in patients with chronic HBV (CHB).• Liver steatosis may co-occur with CHB but its effect on all-cause mortality and cancer has not been determined.• Liver steatosis is significantly associated with allcause mortality and cancer in patients with CHB.• The effect of liver steatosis on mortality and cancer is stronger than the effect of HBV viral load.• Patients with CHB and liver steatosis should be closely monitored, irrespective of their viral load.
Background and Aims: NAFLD and chronic hepatitis B (CHB) infection are common etiologies of HCC. The impact of hepatic steatosis on HCC in CHB, as well as its relationship with the development of cirrhosis, fibrosis, and HBsAg seroclearance, remains controversial.
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