Liver Int. 2020 Feb 22. doi: 10.1111/liv.14415. [Epub ahead of print]
Fatty liver is not independently associated with rates of complete response to oral antiviral therapy in chronic hepatitis B patients.
Li J1,2, Le AK2, Chaung KT2, Henry L2, Hoang JK2, Cheung R2,3, Nguyen MH2.
Author information
1
Department of Infectious Disease, Shandong Provincial Hospital Affiliated to Shandong University, Ji'nan, Shandong, China.
2
Division of Gastroenterology and Hepatology, Stanford University Medical Center, Stanford, CA, USA.
3
Division of Gastroenterology and Hepatology, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA.
Abstract
BACKGROUND & AIMS:
Nonalcoholic fatty liver disease (NAFLD) and chronic hepatitis B (CHB) are common liver diseases. Concurrent NAFLD may affect antiviral treatment outcomes in CHB patients. The aim of this study is to investigate the impact of NAFLD on complete viral suppression [(CVS), HBV DNA < 20-100 IU/mL] and/or biochemical response [(BR), ALT of ≤ 25 U/L for females; 35 U/L for males] in CHB patients who received oral antiviral therapy.
METHODS:
A retrospective study of 555 treated CHB patients (187 NAFLD; 368 non-NAFLD) from 2000 to 2016 at a USA medical center. NAFLD was diagnosed by imaging and/or histology after ruling out secondary causes of hepatic steatosis.
RESULTS:
The majority of patients were male (60.7%), Asian (87.56%), and HBeAg-negative (66.7%). NAFLD patients compared to non-NAFLD were more likely HBeAg negative (74.3% vs. 62.8%, P=0.02), hypertensive (33.2% vs. 22.8%, P=0.009), male (67.4% vs. 57.3%, P=0.02) with a higher mean BMI (25.4±4.3 vs. 23.8±4.0 kg/m2 , P<0.001). Both cohorts achieved similar rates of CVS (86% vs. 88%) and BR (38% vs. 41%) during follow-up of up to 60 months (P>0.05), but NAFLD had higher cumulative rates of CVS+BR, compared with non-NAFLD patients (32.5% vs. 22.8%, P=0.03). In multivariate analyses, NAFLD was not independently associated with CVS and/or BR outcomes. Receipt of entecavir or tenofovir (versus older therapies) and lower baseline HBV DNA or higher ALT were positively associated with achieving CVS or BR.
CONCLUSION:
Concomitant NAFLD had no impact on the long-term rates of CVS and/or BR in treated CHB patients.
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KEYWORDS:
非酒精性脂肪肝疾病(NAFLD)和慢性乙型肝炎(CHB)是常见的肝病。并发NAFLD可能会影响CHB患者的抗病毒治疗结果。这项研究的目的是调查NAFLD对女性完全病毒抑制[(CVS),HBV DNA <20-100 IU / mL]和/或生化反应[(BR),ALT≤25 U / L的影响;在接受口服抗病毒治疗的CHB患者中,男性为35 U / L)。
方法: