Metabolic syndrome increases the risk of liver cirrhosis in chronic hepatitis B

Wong, Grace L.H.; Wong, Vincent Wai‐Sun; Choi, Pui–Wah; Chan, Anthony W.H.; Chim, Angel Mei‐Ling; Yiu, Karen; Chan, HY; Chan, Francis K.L.; Sung, Joseph J.Y.; Chan, H.L.-Y.

doi:10.1136/gut.2008.157735

Cited by 211 publications

(193 citation statements)

References 42 publications

Supporting

Mentioning

185

Contrasting

Unclassified

Order By: Relevance

“…In particular, metabolic factors, including DM and hypertension, were also significantly associated with higher rates of primary adverse outcomes, although DM was not shown to be an independent variable on multivariate analysis. Currently, there are limited data regarding the relationship between chronic HBV infection and metabolic factors (29,30). Wong et al (29) demonstrated that coincidental metabolic syndrome in CHB patients increased the risk of liver fibrosis progression, independent of viral load and hepatitis activity.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, there are limited data regarding the relationship between chronic HBV infection and metabolic factors (29,30). Wong et al (29) demonstrated that coincidental metabolic syndrome in CHB patients increased the risk of liver fibrosis progression, independent of viral load and hepatitis activity. Another study showed that metabolic factor-related hepatic steatosis was significantly associated with antiviral treatment failure in CHB patients (30).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Tenofovir versus Entecavir in Treatment of Chronic Hepatitis B Virus with Severe Acute Exacerbation

Hung

et al. 2015

Antimicrob Agents Chemother

View full text Add to dashboard Cite

bTenofovir disoproxil fumarate (TDF) and entecavir (ETV) are effective antivirals recommended as first-line monotherapies for treatment of chronic hepatitis B (CHB) infection. This study aimed to compare the short-term efficacies of TDF and ETV in the treatment of CHB with severe acute exacerbation. From 2008 to 2013, 189 consecutive treatment-naive CHB patients receiving TDF (n ‫؍‬ 41) or ETV (n ‫؍‬ 148) for severe acute exacerbation were enrolled. The primary endpoint was overall mortality or receipt of liver transplantation by week 24. The baseline characteristics were comparable between these two groups. By week 24, 8 (19% [95% confidence interval {CI}, 7% to 32%]) patients in the TDF group and 26 (18% [95% CI, 11 to 24%]) patients in the ETV group died (n ‫؍‬ 30) or received liver transplantation (n ‫؍‬ 4) (P ‫؍‬ 0.749). The two groups of patients developed similar rates of liver-related complications and achieved comparable biochemical and virological responses at week 24. Cox regression analysis showed that baseline viral DNA level (P ‫؍‬ 0.002), hypertension (P ‫؍‬ 0.002), model for end-stage liver disease (MELD) score (P ‫؍‬ 0.01), platelet count (P ‫؍‬ 0.005), early presence (within 4 weeks) of ascites (P ‫؍‬ 0.005), hepatic encephalopathy (P ‫؍‬ 0.002), and hepatorenal syndrome (P < 0.001) were independent factors for mortality or liver transplantation. Among the patients who survived by week 24, there was no difference between the two groups in the percentage of patients who had a serum creatinine increase of >0.5 mg/dl from baseline (6.7% [95% CI, 0% to 16%] versus 2.0% [95% CI, 0% to 4.8%] in the TDF and ETV groups, respectively; P ‫؍‬ 0.231), whereas a significant reduction in the estimated glomerular filtration rate (eGFR) was found in the two groups (P ‫؍‬ 0.001 for both). In conclusion, TDF and ETV produce a similar treatment response and clinical outcome in patients with severe acute exacerbation of CHB. C hronic hepatitis B virus (HBV) infection is a major global health issue, affecting around 370 million people worldwide (1). Patients with chronic hepatitis B (CHB) are at a significantly increased risk for the development of liver failure, cirrhosis, and hepatocellular carcinoma (HCC) (2). In its natural course, up to 30% of CHB patients experience a spontaneous reactivation of hepatitis every year (3). Severe acute exacerbation of CHB characterized by high serum alanine aminotransferase (ALT) level, jaundice, and hepatic decompensation leads to a high mortality rate, ranging from 30 to 70% (4, 5). Most guidelines recommend treatment with oral nucleos(t)ide analogues (NUCs) for CHB patients with severe acute exacerbation as soon as possible (6-8). Liver transplantation is the salvage treatment if medical therapy fails; however, this is neither readily available nor feasible in many parts of the world where HBV is highly endemic (5, 9). Lamivudine (LAM) was the first effective oral HBV replication-suppressive agent and has been widely used in patients with severe acute exacerbation of CHB (4,...

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Tenofovir versus Entecavir in Treatment of Chronic Hepatitis B Virus with Severe Acute Exacerbation

Hung

et al. 2015

Antimicrob Agents Chemother

View full text Add to dashboard Cite

show abstract

“…The results indicated that pre-existing metabolic syndrome, as defined by the 2001 US NCEP-ATP III criteria, confered a statistically significant 2.13 and 1.56 fold increased risk for terminal liver diseases as HCC and ICC which was independent of other risk factors [33]. Recent data from Chinese and Korean cohorts established that MS is a risk factor of advanced liver fibrosis and cirrhosis independent of viral factors in chronic HBV infection [34,35].…”

Section: Host Related Factors Virus Related Factors Additional Factorsmentioning

confidence: 85%

Impact of Metabolic Syndrome on Fibrosis Progression in Chronic Viral Hepatitis B Infection

Aygün¹

2015

J Metabolic Synd

View full text Add to dashboard Cite

Many factors may increase the risk of fibrosis development in chronic viral hepatitis infections. As the burden of obesity and metabolic syndrome has been increasing in recent years, there is growing concern regarding the association between metabolic factors and chronic viral hepatitis cases. However data regarding the influence of metabolic syndrome on progression of fibrosis in chronic hepatitis B virus (HBV) infection is limited. Metabolic syndrome is a constellation of problems that includes insulin resistance, obesity, hypertension, and hyperlipidemia. Initially, epidemiologic data demonstrated that HBsAg-positive serostatus was positively correlated with a high risk of metabolic syndrome; later on, HBV was considered as a "metabolovirus" because the gene expression of HBV and key metabolic genes in hepatocytes was found to be similarly regulated. Metabolic syndrome is not only found to accelerate the progression of liver disease in patients with chronic HBV infection but also found to induce cirrhosis or even hepatocellular carcinoma development. This review article it is aimed to highlight the association of metabolic syndrome with chronic HBV infection.

show abstract

“…Although LC has been shown to be associated with the occurrence of GERD, the underlying mechanisms which link both diseases together remained largely unknown. Metabolic syndrome, diabetes mellitus and obesity are known risk factors of LC development [23]. Of particular note is that diabetes mellitus, metabolic syndrome and obesity could also increase the risk of GERD [2].…”

Section: Discussionmentioning

confidence: 99%

Increased incidence of gastroesophageal reflux disease in patients with chronic hepatitis B virus infection

et al. 2010

View full text Add to dashboard Cite

Background Although chronic liver disease is associated with gastroesophageal reflux disease (GERD), the impact of chronic hepatitis B virus (HBV) infection on this association remains unclear. We thus aimed to evaluate the relationship between chronic HBV infection and GERD.Methods In this prospective population-based study, 1,001 adult subjects who underwent an upper gastrointestinal endoscopic examination in a health check-up and completed a gastroesophageal reflux questionnaire were consecutively enrolled. Endoscopic findings were classified according to the Los Angeles classification. Hepatitis B surface antigen was used as a marker of HBV infection. Univariate and multivariate approaches were used to evaluate the effects of chronic HBV infection on GERD.Results Chronic HBV infection was associated with heartburn sensation [odds ratio (OR) 1.27, 95% confidence interval 1.01-1.61, P = 0.037], and erosive esophagitis (adjusted OR 1.75, 1.03-2.97, P = 0.037). Although male gender is a risk factor of erosive esophagitis, further analyses stratified by gender and aspartate aminotransferase to platelet ratio index (APRI) showed that chronic HBV infection was associated with erosive esophagitis in female subjects (adjusted OR 2.70, 1.14-6.39, P = 0.024) and those with APRI of more than 0.3 (adjusted OR 3.94, 1.73-8.96, P = 0.001). Moreover, higher serum aspartate aminotransferase (AST) and triglyceride (TG) levels were risk factors of erosive esophagitis in patients with chronic HBV infection. Conclusions Our findings indicate a close association between chronic HBV infection and GERD, especially in female subjects and those with higher APRI levels. Moreover, HBV carriers with higher AST or TG levels have higher incidence of erosive esophagitis. The interactions between chronic HBV infection and GERD need further studies.

show abstract

Metabolic syndrome increases the risk of liver cirrhosis in chronic hepatitis B

Abstract: Metabolic syndrome is an independent risk factor of liver cirrhosis in CHB.

Cited by 211 publications

References 42 publications

Tenofovir versus Entecavir in Treatment of Chronic Hepatitis B Virus with Severe Acute Exacerbation

Tenofovir versus Entecavir in Treatment of Chronic Hepatitis B Virus with Severe Acute Exacerbation

Impact of Metabolic Syndrome on Fibrosis Progression in Chronic Viral Hepatitis B Infection

Increased incidence of gastroesophageal reflux disease in patients with chronic hepatitis B virus infection

Contact Info

Product

Resources

About