Liver Fibrosis is Associated with NAFLD Activity Score in Chronic Hepatitis B Patients with Liver Steatosis

Abstract

Background: Chronic hepatitis B (CHB) and non-alcoholic fatty liver disease (NAFLD) are two leading hepatic diseases that cause severe public health problems. The relationship between the severity of NAFLD and liver fibrosis in CHB patients remains controversial.Objectives: This study aimed at further clarifying the association between them. Methods: A total of 272 CHB patients and 31 NAFLD patients without CHB, who underwent liver biopsies and routine blood tests were included. The NAFLD activity scores (NAS) for NAFLD patients and the METAVIR scoring system for all the patients were used to evaluate the liver pathology. The associations between steatosis or NAS score and liver fibrosis were statistically analyzed. Results: METAVIR F0-4 was identified in 10.0%, 30.5%, 36.0%, 13.2%, and 10.3% of all the CHB patients, respectively. The prevalence of hepatic steatosis in CHB patients was 39.7% (n = 108). Among them, 26.9% (n = 29) of patients had NAS ≥ 5. The severity of fibrosis was not related to the degree of steatosis nor NAS score (P > 0.05) in NAFLD patients without CHB. Similarly, the results suggested that there was no significant difference in the severity of liver fibrosis in CHB patients with varying degrees of steatosis (P > 0.05). However, the severity of liver fibrosis increased with NAS score (P = 0.004) in CHB patients with NAFLD. Conclusions: The severity of liver fibrosis in CHB patients was associated with NAS score, yet not with fat content.

Impact of fatty liver on long-term outcomes in chronic hepatitis B: a systematic review and matched analysis of individual patient data meta-analysis

“…In our study, we excluded 5 studies that did not provide time-to-event data. [41][42][43][44][45] Second, Mao et al 39 included a recent administrative database study with 48,335 CHB patients reported a higher risk of HCC and death in CHB-FL group, which is contrasting to our findings. 19 However, this study included both hepatitis B and C patients, and subgroup analysis of CHB patients did not provide time-to-event data to be included in our study and did not provide details on which factors were being adjusted for.…”

Steatosis, HBV‐related HCC, cirrhosis, and HBsAg seroclearance: A systematic review and meta‐analysis

“…After removing duplicates and screening the titles and abstracts, 135 potentially available studies were identified. Of these, 34 eligible studies7–10,13–42 were included for analysis at the final stage.…”

Physical, Psychological, and Social Challenges in Patients with Hepatitis B Infection

“…In a population-based cohort study in Turkey, liver fibrosis was emphasized as one of the serious complications hepatitis B (16). Another study linked the prevalence of liver fibrosis to the severity of non-alcoholic fatty liver disease in CHB patients (17). The elderly and diabetic people were found more likely to have serious hepatitis B complications, such as HCC (18).…”