Severe Hepatic Steatosis Is Associated With Low-Level Viremia and Advanced Fibrosis in Patients With Chronic Hepatitis B in North America

Gastro Hep Advances

卷:1

Nishi H. Patel¹  Sarah Haylock-Jacobs²  Mang M. Ma³  Karen Doucette³  Giada Sebastiani⁴  Carla S. Coffin⁴  Alnoor Ramji⁵  Curtis Cooper⁶  Erin Kelly⁶  Gerald Minuk⁶  Hin Hin Ko⁷  Scott K. Fung⁸  Magdy Elkhashab⁹  Edward Tam⁹  Philip Wong¹⁰  Alexander Wong¹¹  Robert Bailey¹² 

[1] Correspondence: Address correspondence to: Hin Hin Ko, BSc (Pharm), MD, Clinical Associate Professor, University of British Columbia, 770 – 1190 Hornby Street, Vancouver, British Columbia V6Z 2K5, Canada;

[2] fax: [phone].;

[3] Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada;

[4] Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada;

[5] Department of Medicine, University Health Network, Toronto, Ontario, Canada;

[6] Department of Medicine, University of Alberta, Edmonton, Alberta, Canada;

[7] Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada;

[8] Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada;

[9] Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada;

[10] Department of Medicine, University of Saskatchewan, Regina, Saskatchewan, Canada;

[11] Depatment of Medicine, Pacific Gastroenterology Associates, Vancouver, British Columbia, Canada;

[12] Depatment of Medicine, Toronto Liver Centre, Toronto, Ontario, Canada;

关键词: Hepatitis B;    Hepatic Steatosis;    Controlled Attenuated Parameter (CAP);    Transient Elastography (TE);    Fatty Liver Disease;   

DOI  :  

来源: DOAJ

【 摘 要 】

Background and Aims: The obesity epidemic has increased the risk of nonalcoholic fatty liver disease (NAFLD) in both the general and chronic hepatitis B (CHB) populations. Our study aims to determine the prevalence of NAFLD in patients with CHB based on controlled attenuation parameter (CAP) and the epidemiological, clinical, and virological factors associated with severe hepatic steatosis. Methods: The Canadian Hepatitis B Network cohort was utilized to provide a cross-sectional description of demographics, comorbidities, antiviral treatment, and hepatits B virus (HBV) tests. Liver fibrosis and steatosis were measured by transient elastography and CAP, respectively. Any grade and severe steatosis were defined as CAP >248 and >280 dB/m, respectively. Advanced liver fibrosis was defined as transient elastography measurement >10.7 kPa. Results: In 1178 patients with CHB (median age: 47.4%, 57.7% males, 75.7% Asian, 13% African, 6.5% White, 86% HBV e antigen negative, median HBV DNA of 2.44 log10IU/mL, 42.7% receiving treatment), the prevalence of any grade and severe steatosis was 53% and 36%, respectively. In the multivariate analysis, obesity was a significant predictor for severe steatosis (adjusted odds ratio: 5.046, 95% confidence interval: 1.22–20.93). Severe steatosis was a determinant associated with viral load (adjusted odds ratio: 0.385, 95% confidence interval: 0.20–0.75, P < .01; r = −0.096, P = .007) regardless of antiviral therapy, age, and alanine aminotransferase levels. Conclusion: In this large multiethnic CHB population, hepatic steatosis is common. Severe steatosis is independently associated with higher fibrosis, but negatively with HBV DNA, regardless of antiviral therapy history.

【 授权许可】

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