Association Between Fatty Liver and Cirrhosis, Hepatocellular Carcinoma, and Hepatitis B Surface Antigen Seroclearance in Chronic Hepatitis B.

Abstract

BACKGROUND:

Chronic hepatitis B (CHB) and fatty liver (FL) are common, natural history data on concurrent FL and CHB (FL-CHB) are limited. This study aimed to evaluate the effect of FL on cirrhosis, hepatocellular carcinoma (HCC), and hepatitis B surface antigen (HBsAg) seroclearance incidence in CHB patients.

METHODS:

In a retrospective cohort study of 6786 adult CHB patients, we used propensity score matching (PSM) to balance the FL-CHB and non-FL CHB groups. Kaplan-Meier methods were used to compare cumulative cirrhosis, HCC, and HBsAg seroclearance rates between subgroups.

RESULTS:

Before PSM, compared to non-FL CHB, FL-CHB patients had lower 10-year cumulative rates of cirrhosis, HCC, and a higher HBsAg seroclearance rate. Similar results were found in the matched FL-CHB and non-FL CHB patients, as well as in the antiviral-treated PSM cohort. Cox proportional hazards model indicated FL to remain significantly and strongly associated with lower risk of cirrhosis and HCC (hazard ratio [HR], 0.19 [95% confidence interval {CI}, .12-.33], P < .001 and HR, 0.21 [95% CI, .09-.51], P = .001, respectively) in antiviral-treated patients but not in untreated patients.

CONCLUSIONS:

FL was significantly associated with lower cirrhosis and HCC risk and higher HBsAg seroclearance. Further studies are needed to confirm our funding and investigate the mechanisms underlying the impact of FL on CHB.

• Authors: Jie Li, Hwai-I Yang, Ming-Lun Yeh, Michael H Le, An K Le, Yee Hui Yeo, Chia-Yen Dai, Scott Barnett, Jian Q Zhang, Jee-Fu Huang, Huy N Trinh, Christopher Wong, Clifford Wong, Joseph K Hoang, Ramsey Cheung, Ming-Lung Yu, Mindie H Nguyen
• Journal: The Journal of infectious diseases (J Infect Dis) Vol. 224 Issue 2 Pg. 294-302 (07 15 2021) ISSN: 1537-6613 [Electronic] United States
• PMID: 33249474 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: [email protected].

Chemical References

• Antiviral Agents
• Hepatitis B Surface Antigens

Topics

• Adult
• Antiviral Agents (therapeutic use)
• Carcinoma, Hepatocellular (epidemiology)
• Fatty Liver (epidemiology)
• Hepatitis B Surface Antigens (blood)
• Hepatitis B, Chronic (complications, drug therapy)
• Humans
• Liver Cirrhosis (epidemiology)
• Liver Neoplasms (epidemiology)
• Retrospective Studies