Interactions of Hepatitis B Virus Infection with Nonalcoholic Fatty Liver Disease: Possible Mechanisms and Clinical Impact

Abstract

Hepatitis B virus (HBV) infection is a major etiology of chronic liver disease worldwide. In the past decade, nonalcoholic fatty liver disease (NAFLD) has emerged as a common liver disorder in general population. Accordingly, the patient number of chronic hepatitis B (CHB) concomitant with NAFLD grows rapidly. The present article reviewed the recent studies aiming to explore the relationship between CHB and NAFLD from different aspects, including the relevant pathogenesis of CHB and NAFLD, the intracellular molecular mechanisms overlaying HBV infection and hepatic steatosis, and the observational studies with animal models and clinical cohorts for analyzing the coincidence of the two diseases. It is concluded that although numerous cross-links have been suggested between the molecular pathways in HBV infection and NAFLD pathogenesis, regarding whether HBV infection can substantially interfere with the occurrence of NAFLD or vice versa in the patients, there is still far from a conclusive agreement.

Chronic hepatitis B virus infection and risk of dyslipidaemia: A cohort study

“…In the present large‐scale cohort study of apparently healthy individuals, we demonstrated a longitudinal association between HBsAg positivity and the development of dyslipidaemia over time. HBV carriers may be more likely to have a healthy lifestyle favourably affecting cholesterol levels compared to non‐carriers . However, in our study, the inverse association of HBsAg positivity with lipid parameters including total cholesterol, LDL‐C, triglycerides, non‐HDL cholesterol, apoA1 and apoB persisted after adjusting for possible confounders including smoking, alcohol intake, exercise, and BMI.…”

“…Fourth, differences between HBsAg‐positive and ‐negative subjects may exist in lifestyle, including smoking, alcohol use, physical activity and diet. Previous studies reported that HBV‐infected patients are more likely to have healthy life habits and to avoid risk factors that could contribute to adverse health outcomes . In order to control for potential confounding variables including smoking, alcohol use and physical activity, we adjusted for those confounders in our model and found an independent association between hepatitis B infection and a lower risk of incident dyslipidaemia.…”

The Effect of Hepatosteatosis on Response to Antiviral Treatment in Patients with Chronic Hepatitis B: A Meta-Analysis

“…Due to increase in consumption of fat-rich diet coupled with sedentary lifestyle, the incidence of NAFLD is increasing [8]. Thus, the frequency of patients with CHB and concomitant NAFLD is also increasing.…”

“…Early stage of NAFLD is defined as the presence of steatosis in more than 5% of hepatocytes [8]. HBV X protein is reported to induce hepatic steatosis by enhancing the expression of liver fatty acid binding proteins [9].…”

“…HBV X protein is reported to induce hepatic steatosis by enhancing the expression of liver fatty acid binding proteins [9]. Recent studies have revealed a relatively common finding of steatosis in CHB patients; further, the incidence of steatosis is much higher in patients with CHB as compared to that in the general population, implying its role in CHB [8] Moreover, both HBV infection and steatosis can lead to necroinflammation in the liver. Thus, it is difficult to distinguish the cause of hepatic necroinflammation.…”