Application of Fatty Liver Inhibition of Progression Algorithm and Steatosis, Activity, and Fibrosis Score to Assess the Impact of Non-Alcoholic Fatty Liver on Untreated Chronic Hepatitis B Patients

Frontiers in Cellular and Infection Microbiology

Cellular and Infection Microbiology

Lu Chen¹  Wei Cai¹  Yan Huang¹  Weijing Wang¹  Gangde Zhao¹  Zike Sheng¹  Qinyi Gan¹  Rongtao Lai¹  Qing Xie¹  Simin Guo¹  Hui Wang¹  Qing Guo¹  Zhujun Cao¹ 

[1] Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China;

关键词: hepatitis B;    non-alcoholic fatty liver disease (NAFLD);    non-alcoholic steatohepatitis (NASH);    liver biopsy;    liver fibrosis;   

DOI  :  10.3389/fcimb.2021.733348

 received in 2021-06-30, accepted in 2021-12-13,  发布年份 2022

来源: Frontiers

【 摘 要 】

Backgrounds and PurposeConcurrent non-alcoholic fatty liver disease (NAFLD) in chronic hepatitis B (CHB) patients is a frequent and increasingly concerning problem because of the NAFLD pandemic. Admittedly, NAFLD can progress to non-alcoholic steatohepatitis (NASH) and severe fibrosis. Direct evidence of the fibrotic effect of NAFLD or NASH in chronic hepatitis B virus (HBV) infection remains lacking. We aimed to reveal the influence of concurrent histologically proven fatty liver diseases in fibrogenesis with chronic HBV infection.MethodsWe performed a retrospective cross-sectional study on a liver biopsy population of CHB patients without excessive alcohol intake to evaluate the prevalence of concurrent histologically proven NAFLD or NASH according to the fatty liver inhibition of progression (FLIP) algorithm and its association with the liver fibrosis stage.ResultsAmong 1,081 CHB patients, concurrent NAFLD was found in 404 patients (37.4%), among whom 24.0% (97/404) have NASH. The presence of NASH was an independent predictor of significant fibrosis (odds ratio (OR), 2.53; 95% CI, 1.52–4.21; p < 0.001) and severe fibrosis (OR, 1.83; 95% CI, 1.09–3.09; p = 0.023) in all patients, as well as in patients with normal alanine aminotransferase (ALT) (predicting significant fibrosis, OR, 2.86, 95% CI, 1.34–6.10; p = 0.007). The presence of lobular inflammation (p < 0.001) or presence of cytological ballooning (p < 0.001), rather than presence of steatosis (p = 0.419), was related with severity of fibrosis in Spearman’s correlation analysis.ConclusionsConcurrent NAFLD is common in CHB patients, and NASH is an independent risk factor potentiating significant fibrosis by 2.53-fold and severe fibrosis by 1.83-fold. While coping with chronic HBV infection, routine assessment of co-existing NAFLD or NASH is also important.

【 授权许可】

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Copyright © 2022 Huang, Gan, Lai, Wang, Guo, Sheng, Chen, Guo, Cai, Wang, Zhao, Cao and Xie