慢性乙型肝炎患者的脂肪性肝炎的流行及其对疾病严重性和

StephenW

The Prevalence of Steatohepatitis in Chronic Hepatitis B Patients and Its Impact on Disease Severity and Treatment Response
Authors

    Accepted manuscript online: 14 October 2016Full publication history
    DOI: 10.1111/liv.13271View/save citation
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    This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1111/liv.13271

Abstract
Background & Aims

The clinical significance of steatohepatitis in chronic hepatitis B (CHB) remains unclear. This study aimed to determine the prevalence and risk factors for steatohepatitis in CHB, and to determine its correlation with liver fibrosis and response to antiviral therapy.
Methods

Liver histopathology of 256 consecutive CHB patients with serum HBV DNA >2,000 IU/ml were analyzed with clinical and laboratory characteristics. Virological and biochemical responses were prospectively assessed in the 112 patients treated with antiviral monotherapy.
Results

Hepatic steatosis was observed in 38% of the entire cohort, and steatohepatitis was diagnosed in 18% of patients with hepatic steatosis according to Brunt's classification. The presence of steatohepatitis was associated with overweight/obese (odds ratio [OR], 5.99; 95% CI, 1.32-27.2) and hypertriglyceridemia (OR, 2.95; 95% CI, 1.07-8.15). None of the viral characteristics including HBeAg status, genotypes and viremia levels was associated with the presence of steatohepatitis. Steatohepatitis was an independent predictor of significant fibrosis (OR, 10.0; 95% CI, 2.08-48.5) and advanced fibrosis (OR, 3.45; 95% CI, 1.11-10.7) after adjusting for viremia levels and features of the metabolic syndrome. The rates of suppression of serum HBV DNA <20 IU/ml combined with aminotransferase normalization at week 48 of antiviral therapy were not different between the steatohepatitis and non-steatohepatitis groups (43% vs. 53%; p=0.475).
Conclusions

Steatohepatitis is not uncommon in CHB patients. It is associated with metabolic syndrome but not viral factor. This study demonstrates that steatohepatitis is related to the severity of liver fibrosis but it does not affect response to antiviral therapy.

StephenW

慢性乙型肝炎患者的脂肪性肝炎的流行及其对疾病严重性和治疗反应的影响
作者

    在线接受稿件：14十月2016完整的出版历史
    DOI：10.1111 / liv.13271查看/保存引文
    引用：0文章

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    本文已被接受发布，并经过完整的同行评审，但没有通过复制，排版，分页和校对过程，这可能导致此版本和记录版本之间的差异。请引用本文作为doi：10.1111 / liv.13271

抽象
背景与目的

脂肪性肝炎在慢性乙型肝炎（CHB）的临床意义仍不清楚。本研究旨在确定CHB中脂肪性肝炎的患病率和危险因素，并确定其与肝纤维化和抗病毒治疗反应的相关性。
方法

对256名连续CHB患者的血清HBV DNA> 2,000 IU / ml的肝组织病理学进行了临床和实验室特征分析。病毒学和生化反应在112例接受抗病毒单药治疗的患者中进行前瞻性评估。
结果

在整个队列中观察到38％的肝脂肪变性，根据Brunt分类，在18％的肝脂肪变性患者中诊断出脂肪性肝炎。脂肪性肝炎的存在与超重/肥胖（优势比[OR]，5.99; 95％CI，1.32-27.2）和高甘油三酯血症（OR，2.95; 95％CI，1.07-8.15）相关。没有病毒特征包括HBeAg状态，基因型和病毒血症水平与脂肪性肝炎的存在相关。在调整病毒血症水平和代谢综合征的特征后，脂肪性肝炎是显着纤维化（OR，10.0; 95％CI，2.08-48.5）和晚期纤维化（OR，3.45; 95％CI，1.11-10.7）的独立预测因子。在抗病毒治疗的第48周，血清HBV DNA <20 IU / ml的抑制率与转氨酶正常化的比率在脂肪性肝炎和非脂肪性肝炎组之间没有差异（43％对53％; p = 0.475）。
结论

脂肪性肝炎在CHB患者中并不罕见。它与代谢综合征相关，但不是病毒因子。这项研究表明，脂肪性肝炎与肝纤维化的严重性有关，但它不影响对抗病毒治疗的反应。

四十己过

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