Hepatitis B virus infection and risk of non‐alcoholic fatty liver disease: A population‐based cohort study

Zhu, Liguo; Jiang, Jie; Zhai, Xiangjun; Baecker, Aileen; Peng, Hong; Jiao, Qian; Zhou, Minghao; Song, Ci; Zhou, Yan; Xu, Jianfang; Liu, Hongjian; Hua, Dong; Hu, Zhibin; Shen, Hongbing; Zhang, Zuo‐Feng; Zhu, Fengcai

doi:10.1111/liv.13933

Cited by 54 publications

(49 citation statements)

References 30 publications

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“…In addition, Viganò et al retrospectively analysed 235 treatment‐naïve patients with CHB and found that biopsy‐proven liver steatosis was not associated with virologic factors, such as HBeAg status or HBV‐DNA load. Moreover, Zhu et al followed 2393 Chinese patients with CHB who had no history of alcohol intake or NAFLD over a ‐year period, and found no association between viral factors and NAFLD incidence rate. Therefore, HBV itself might not be associated with NAFLD independently.…”

Section: Decreased Risk Of Nafld Onset In Patients With Hbv Infectionmentioning

confidence: 99%

Chronic hepatitis B and non‐alcoholic fatty liver disease: Conspirators or competitors?

Zhang

Lin

Jiang

et al. 2020

Liver International

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Despite the widespread use of vaccines and antiviral drugs, approximately 350‐400 million patients with chronic hepatitis B (CHB) remain worldwide, who carry high risk of cirrhosis and liver carcinoma. Moreover, owing to improvements in global living standards and lifestyle changes, non‐alcoholic fatty liver disease (NAFLD) has become the most common chronic liver disease. Coexistence of NAFLD and CHB is commonly observed, especially in Asian CHB populations; however, little is known regarding the relationship between these two diseases as comorbidities. In this review, we summarize recent advances in clinical and basic researches related to the underlying mutual interactions, as well as potential animal models to facilitate further investigation.

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Section: Decreased Risk Of Nafld Onset In Patients With Hbv Infectionmentioning

confidence: 99%

Chronic hepatitis B and non‐alcoholic fatty liver disease: Conspirators or competitors?

Zhang

Lin

Jiang

et al. 2020

Liver International

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“…The prevalence of NAFLD in patients with CHB ranges from 18% to 40% . Concomitant metabolic factors play an important role in the development of NAFLD amongst CHB patients and increase the risk of liver disease progression independent of viral load or hepatitis activity . However, whether NAFLD interferes with LSM values in CHB patients is still unclear.…”

Section: Introductionmentioning

confidence: 99%

Moderate to severe hepatic steatosis leads to overestimation of liver stiffness measurement in chronic hepatitis B patients without significant fibrosis

Shen

et al. 2019

Aliment Pharmacol Ther

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Background: Liver stiffness measurement (LSM) by transient elastography is a noninvasive method for the diagnosis of hepatic fibrosis. The impact of hepatic steatosis on LSM remains to be explored. Aim:To determine whether LSM is affected by hepatic steatosis in patients with chronic hepatitis B (CHB). Methods:Consecutive patients with biopsy-proven CHB were prospectively enrolled. Hepatic steatosis was classified by pathology as none (S0, <5%), mild (S1, 5%-33%), and moderate-severe (S2-3, >33%), and quantitatively by controlled attenuation parameter (CAP) as CAP S0 (≤247 dB/m), CAP S1 (248-267 dB/m) and CAP S2-3 (≥268 dB/m). Liver fibrosis was assessed by METAVIR classification and noninvasively by LSM.

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“…Patients with elevated ALT of more than 35 were 166 (72.2%) and 143 (62.2%) had moderate to severe liver steatosis as determined by the controlled attenuation parameter. A population-based Chinese cohort study underscored the importance of metabolic factors as a cause of NAFLD in hepatitis B and excluded any possible relationship between viral factors and NAFLD but observed that in a subgroup of subjects with concurrent type 2 diabetes mellitus, detectable HBV DNA levels were negatively associated with the development of NAFLD (HR, 0.37; 95% CI, 0.14‐0.98) [11]. Peng D, by using liver biopsy as a tool, concluded that apart from metabolic factors, the hepatitis B virus indirectly facilitates the development of steatosis, as there existed a correlation between ALT levels, HBV DNA, and steatosis [12].…”

Section: Discussionmentioning

confidence: 99%

Effect of Non-alcoholic Fatty Liver Disease on Transaminase Levels and Transient Elastography in Patients with Chronic Hepatitis B

Sharif

Abbas

Ahmed

et al. 2019

Cureus

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ObjectiveTo investigate the effects of non-alcoholic fatty liver disease on aminotransferase (ALT) levels and transient elastography in patients with chronic hepatitis B (CHB).MethodsA cross-sectional study of 230 patients with CHB and ALT levels up to two times the upper limits of normal, of one-year duration, from June 2018 to May 2019. The demographic, clinical, and laboratory characteristics of each patient were collected. Transient elastography was performed to evaluate controlled attenuation parameter (CAP or steatosis) and liver stiffness (fibrosis).ResultsA total of 161 (70%) patients were overweight, with over two-thirds (166; 72.2%) having elevated ALT >35 U/L. Three-fourths of the patients (178; 77.4%) had a hepatitis B virus (HBV) deoxyribonucleic (DNA) level of less than 2000 IU/ml. Steatosis was detected in 166 (72.2%) patients while fibrosis of F2 or more in 88 (38.3%). Multivariate regression analysis showed that weight, homeostatic model assessment of insulin resistance (HOMA-IR), and elevated ALT levels of more than 35 were independently associated with higher CAP values (p= 0.019, 0.001, and 0.004, respectively). Age, insulin levels, and platelet counts were independently associated with liver elasticity (p=0.00, 0.002, and 0.028, respectively). HBV DNA levels did not show any significant association with CAP score, liver stiffness, and HOMA-IR or ALT level. Among those with an elevated ALT of 35 or above (n=166), 124 patients had HBV DNA levels less than 2000 IU/ml. Out of these, 97 (78.2%) patients had steatosis and 51 (41.1%) had F2 or more fibrosis.ConclusionA significant number of patients with CHB with mildly elevated ALT levels are overweight, have significant steatosis and fibrosis, but low HBV DNA levels. This aspect is important while making decisions regarding hepatitis B treatment.

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Hepatitis B virus infection and risk of non‐alcoholic fatty liver disease: A population‐based cohort study

Abstract: Metabolic factors play an important role in the presence of NAFLD among Chinese CHB patients. However, viral replication factors are not related to NAFLD except among those with concurrent type 2 DM.

Cited by 54 publications

References 30 publications

Chronic hepatitis B and non‐alcoholic fatty liver disease: Conspirators or competitors?

Chronic hepatitis B and non‐alcoholic fatty liver disease: Conspirators or competitors?

Moderate to severe hepatic steatosis leads to overestimation of liver stiffness measurement in chronic hepatitis B patients without significant fibrosis

Effect of Non-alcoholic Fatty Liver Disease on Transaminase Levels and Transient Elastography in Patients with Chronic Hepatitis B

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