Association between Hepatic Steatosis and Entecavir Treatment Failure in Chinese

StephenW

PLoS One. 2012;7(3):e34198. Epub  2012 Mar 30.
Association between Hepatic Steatosis and Entecavir Treatment Failure in Chinese Patients with Chronic Hepatitis B.Jin X, Chen YP, Yang YD, Li YM, Zheng L, Xu CQ.
SourceDepartment of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.

AbstractBACKGROUND: The coexistence of HBV infection and nonalcoholic fatty liver disease (NAFLD) becomes characteristic of liver disease in China, with unknown bilateral influence. We aimed to investigate the effect of hepatic steatosis, a common hepatocyte change in NAFLD, on antiviral therapy in patients with chronic hepatitis B (CHB).
METHODS AND FINDINGS: We carried out a prospective nested case control study in CHB patients receiving Entecavir for initial antiviral therapy, by recording demographic, anthropometric and clinical data at baseline, 24(wk), 48(wk) and 96(wk). Univariate analysis and multivariate logistic regression were applied to find out independent factors of hepatic steatosis and Entecavir treatment failure. The rates of HBV-DNA clearance, HBeAg seroconversion and ALT normalization were compared between CHB patients with and without steatosis by post hoc analysis. A total of 267 Chinese patients with CHB entered final analysis, with overall percentages of hepatic steatosis and HBeAg positive as 30.5% and 62.4%. Multivariate analysis showed waist circumference, serum TG and uric acid levels were independent factors of hepatic steatosis. The response rates to Entecavir were 54.9%, 63.8%, 74.2% at 24(wk), 48(wk) and 96(wk). Hepatic steatosis was revealed as an independent factor of Entecavir treatment failure by multivariate logistic regression at 24(wk), 48(wk) and 96(wk). In CHB patients with hepatic steatosis, HBV-DNA clearance and HBeAg seroconversion were both lower throughout the follow-up, but only the former reached statistical significance. Besides, ALT normalization was also significantly lower at 24(wk) and 48(wk).
CONCLUSION: Hepatic steatosis is significantly associated with Entecavir treatment failure and metabolic factors are independent factors of hepatic steatosis in CHB patients, which called for a specified antiviral strategy in CHB patients with NAFLD


Figure 1
Schematic representation of the selection process for CHB patients receiving initial antiviral therapy.

StephenW

PloS one。 2012年7（3）：e34198。出处2012年03月30日。
协会之间在中国慢性乙型肝炎患者的脂肪肝和恩替卡韦治疗失败
金的X，陈黄页，耶青杨，李YM，郑大号，徐重庆。
源

消化内科医学院附属第一医院，浙江大学，杭州，中国。
抽象
背景：

乙肝病毒感染和非酒精性脂肪性肝病（NAFLD）的共存成为肝脏疾病的特点，在中国，与未知的双边影响。我们的目的是探讨在慢性乙型肝炎（CHB）患者的抗病毒药物治疗，脂肪肝的作用，共同在非酒精性脂肪肝肝细胞的变化。
方法和结果：

我们开展了人口，人体和临床数据记录在基线，24（周），48（周）和96（周），接受恩替卡韦初始抗病毒治疗慢性乙型肝炎患者的前瞻性巢式病例对照研究。单因素分析和多因素logistic回归被查出脂肪肝和恩替卡韦治疗失败的独立危险因素。 HBV-DNA的清除率，HBeAg血清转换和ALT正常化之间的事后分析与无脂肪的慢性乙型肝炎患者进行了比较。共有267中国慢性乙型肝炎患者进入最后的分析，脂肪肝和HBeAg阳性为30.5％和62.4％的整体百分比。多因素分析显示腰围，血清甘油三酯和尿酸水平是脂肪肝的独立危险因素。恩替卡韦的回应率分别为54.9％，63.8％，74.2％在24（周），48（周）和96（周）。多因素logistic回归（24周），48（周）和96（周），脂肪肝，发现恩替卡韦治疗失败的独立危险因素。在慢性乙型肝炎患者肝，脂肪肝，清除，HBV-DNA和HBeAg血清转换既降低整个的后续行动，但只有前者达到统计学意义。此外，ALT正常化24（周）和48（周）也显着降低。
结论：

脂肪肝明显与恩替卡韦治疗失败和代谢因素相关的慢性乙型肝炎患者，其中指定的慢性乙型肝炎患者与非酒精性脂肪肝的抗病毒药战略脂肪肝的独立危险因素。

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