Effect of hepatic steatosis on the progression of chronic hepatitis B: A prospective cohort and <i>in vitro</i> study

Chen, Yangqin; Chen, Yuhan; Liu, Hui; Wang, Shanshan; Dong, Paul R; Li, Lei; Ding, Huiguo

doi:10.18632/oncotarget.17380

Cited by 20 publications

(27 citation statements)

References 26 publications

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“…Elevated BMI in association with hepatitis could support the diagnosis of underlying nonalcoholic liver disease (NAFLD). Several studies have suggested that NAFLD can have a synergistic effect on viral oxidative stress in hepatocytes, ( 14 ) predisposing children to higher liver enzyme elevations during a viral infection. The only patient who developed multiorgan failure and severe hepatitis was obese.…”

Section: Discussionmentioning

confidence: 99%

Acute Hepatitis Is a Prominent Presentation of the Multisystem Inflammatory Syndrome in Children: A Single‐Center Report

et al. 2020

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Background and Aims A newly recognized multisystem inflammatory syndrome in children (MIS‐C) has had a paradigm‐shifting effect on the perception of severe acute respiratory syndrome, coronavirus‐2 (SARS‐CoV‐2) illness severity in children. We report the clinical and biochemical features of liver involvement, and the comorbidities that present with hepatitis, in a substantial cohort of patients. Approach and Results This is a retrospective cohort study of 44 patients with MIS‐C admitted at Morgan Stanley Children’s Hospital of New York‐Presbyterian during April and May 2020. We evaluated the number of patients who developed hepatitis and examined both demographics and inflammatory laboratory values to ascertain those that were at higher risk for liver involvement and more severe disease. Hepatitis was present in 19 subjects (43%) and was associated with more severe disease. Persons with hepatitis had significantly higher rates of shock at presentation (21.1% vs. 0%; P = 0.008), greater respiratory support requirement (42.1% vs. 12%; P = 0.005), and longer hospitalization times (median, 7 [interquartile range {IQR}, 5, 10] vs. 4 days [IQR, 3.5, 6.5]; P < 0.05). Patients with hepatitis also had significantly higher levels of ferritin (706.9 vs. 334.2 mg/mL; P < 0.01), interleukin‐6 (233.9 vs. 174.7 pg/mL; P < 0.05), troponin (83.0 vs. 28.5 ng/L; P < 0.05), and B‐type natriuretic peptide (7,424.5 vs. 3,209.5 pg/mL; P < 0.05). The single patient with liver failure also developed multiorgan failure requiring vasopressors, hemodialysis, and mechanical ventilation. All patients were discharged, though >50% had persistent hepatitis up to 1 month after discharge. Conclusions Hepatitis is common in children with MIS‐C and is associated with a more severe presentation and persistent elevation of liver function tests in many. Despite the positive outcomes reported here, close follow‐up is warranted given the limited knowledge of the long‐term impact of SARS‐CoV‐2 on the liver.

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Section: Discussionmentioning

confidence: 99%

Acute Hepatitis Is a Prominent Presentation of the Multisystem Inflammatory Syndrome in Children: A Single‐Center Report

et al. 2020

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“…Recently, Chen et al 21 studied oleic acid–induced hepatic steatosis cells in vitro and found that cell steatosis does promote proliferation and migration of HCC cells. However, clinical results in follow-up patients regarding HCC development and CHB do not show similar data.…”

Section: Discussionmentioning

confidence: 99%

Presence of Hepatic Steatosis Does Not Increase the Risk of Hepatocellular Carcinoma in Patients With Chronic Hepatitis B Over Long Follow-Up

Lim

Goh

et al. 2020

Microbiol�Insights

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Background: Chronic hepatitis B (CHB) infection and nonalcoholic fatty liver disease (NAFLD) are liver diseases which may lead to hepatocellular carcinoma (HCC) formation. Both disease entities have been attributed independently to increase risk of HCC development. While concomitant hepatic steatosis in patients with CHB are becoming more frequent in view of increasing NAFLD prevalence, there is no conclusive evidence linking presence of hepatic steatosis and increased HCC risk in patients with CHB infection. This study explores the association of hepatic steatosis among CHB-infected individuals in HCC development. Methods: This is a retrospective study on a cohort of patients with CHB who underwent liver biopsy between January 2000 and December 2014. They were stratified according to presence and severity of histologically proven hepatic steatosis and subsequently followed up to evaluate the association between hepatic steatosis and HCC development. Results: Among 289 patients with a median follow-up of 111.1 months, hepatic steatosis was present in 185 patients (64.0%). In all, 27 patients developed HCC on follow-up and 21 of them had hepatic steatosis. Univariate Cox analysis showed that age (hazard ratio [HR] = 1.08, 95% CI = 1.042-1.12), type 2 diabetes mellitus (T2DM) (HR = 4.00, 95% CI = 1.622-9.863), and Ishak score (HR = 1.221, 95% CI = 1.014-1.472) were associated with HCC development, whereas multivariate Cox analysis demonstrated that age and T2DM (HR = 2.69, 95% CI = 1.072-6.759) were significant risk factors for development of HCC. Conclusions: Concurrent hepatic steatosis in patients with CHB infection is not a risk factor for hepatocellular carcinoma formation.

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“…Meanwhile, NAFLD, which includes steatosis with or without necroinflammation, has emerged as another major and common cause of liver injury in the general population. As it can result in hepatocellular carcinoma, cirrhosis, and liver failure,9 it is one of the most targeted liver disorders for prevention and treatment. Researchers have concluded that host factors including metabolic syndrome provide conditions for developing fatty liver and steatohepatitis in patients with CHB,16 and liver fibrosis may be more frequent in this situation 20.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have revealed that steatosis (such as NAFLD) and chronic viral hepatitis (including chronic HBV [CHB]) have a synergistic effect on aggravating liver injury through oxidative damage, so their coincidence could promote hepatic fibrosis and hepatocellular carcinoma 7,9. On the other hand, according to various previous studies, NAFLD is strongly associated with obesity, type 2 diabetes, and metabolic syndrome,10,12 especially when in combination with CHB 13,16.…”

Section: Introductionmentioning

confidence: 99%

<p>Analysis Of Risk Factors For Nonalcoholic Fatty-Liver Disease In Hepatitis B Virus Infection: A Case–Control Study</p>

Azarkar¹,

Doosti²,

Osmani³

et al. 2019

HMER

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BackgroundNonalcoholic fatty-liver disease (NAFLD) is the most common cause of chronic liver disease worldwide. Although NAFLD has been studied extensively, potential risk factors for NAFLD among chronic hepatitis B (CHB) patients and their comparison with healthy individuals have remained understudied in Iran. As such, we examined the association between HBV infection and the development of NAFLD in two groups.MethodsA case–control study was done on 376 CHB patients and 447 healthy subjects randomly selected from Birjand, South Khorasan province, Iran. We used logistic regression to estimate adjusted ORs with 95% CIs for incidence of NAFLD. Potential risk factors for NAFLD were evaluated while adjusting for age, sex, marital status, and educational level. Also, χ2 was used to compare demographic characteristics between the two groups.ResultsA total of 373 CHB patients (mean age 40.1±12.9 years) versus 447 individuals in the control group (mean age 39.8±13.9 years) were included in this study (p=0.337). Liver characteristics were found to be significantly different in CHB and healthy groups (p<0.05). According to the results obtained from logistic regression, the adjusted OR (95% CI) for NAFLD incidence of comparing HBsAg-positive to HBsAg-negative participants was 0.62 (0.45–0.84).ConclusionThe results suggested that HBsAg seropositivity was associated with lower risk of developing NAFLD. This study also revealed that mild cases of fatty liver in carriers of hepatitis B are more common than in healthy subjects. However, moderate and severe cases of this condition are more common in healthy people than in hepatitis B carriers.

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Effect of hepatic steatosis on the progression of chronic hepatitis B: A prospective cohort and in vitro study

Cited by 20 publications

References 26 publications

Acute Hepatitis Is a Prominent Presentation of the Multisystem Inflammatory Syndrome in Children: A Single‐Center Report

Acute Hepatitis Is a Prominent Presentation of the Multisystem Inflammatory Syndrome in Children: A Single‐Center Report

Presence of Hepatic Steatosis Does Not Increase the Risk of Hepatocellular Carcinoma in Patients With Chronic Hepatitis B Over Long Follow-Up

<p>Analysis Of Risk Factors For Nonalcoholic Fatty-Liver Disease In Hepatitis B Virus Infection: A Case–Control Study</p>

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