Hepatic Steatosis and Steatohepatitis in a Large North American Cohort of Adults With Chronic Hepatitis B
Year: 2021
Type: article
Study design: Observational Study
Abstract: INTRODUCTION: Fatty liver disease (FLD) influences liver disease progression and liver cancer risk. We investigated the impact of FLD on liver disease severity in a large North American cohort with chronic hepatitis B virus (HBV). METHODS: Liver biopsies from 420 hepatitis B surface antigen-positive adults enrolled in the Hepatitis B Research Network and who were not on HBV therapy in the previous month were evaluated for inflammation and fibrosis. Steatohepatitis was based on steatosis, hepatocyte ballooning ± Mallory-Denk bodies, and perisinusoidal fibrosis. Models evaluated factors associated with steatohepatitis, and the associations of steatohepatitis with fibrosis, and longitudinal alanine aminotransferase, aspartate aminotransferase, and Fibrosis-4. RESULTS: The median age was 42 years, 62.5% were male, and 79.5% were Asian. One hundred thirty-two (31.4%) patients had FLD (77 [18.3%] steatosis only, 55 [13.1%] steatohepatitis). Older age, overweight/obesity, and diabetes were associated with steatohepatitis. Steatohepatitis (vs no FLD) was associated with 1.68 times higher risk of advanced fibrosis at baseline (95% confidence interval, 1.12-2.51), and there was an indication of higher incident cirrhosis rate during follow-up. Steatohepatitis vs no FLD was also independently associated with, on average, 1.39 times higher alanine aminotransferase (P < 0.01) and 1.25 times higher Fibrosis-4 (P = 0.04) across 4 years. DISCUSSION: Coexisting steatosis occurred in nearly a third of adults (13% had steatohepatitis) with chronic HBV in this North American cohort who underwent liver biopsies. Steatohepatitis was associated with advanced fibrosis and higher biochemical measures of hepatic inflammation over time. Therefore, in addition to viral suppression, screening for and managing metabolic abnormalities is important to prevent disease progression in HBV.
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: Hepatitis B Clinical Research Network, Hepatitis B Research Network (HBRN): Natural History and Treatment Studies, Mentoring Multidisciplinary Patient-Oriented Research in Liver Disease, Immunologic and Virologic Correlates of the Age-Related Decrease in HBV DNA in Children, Hepatitis B Research Network Clinical Centers, Hepatitis B Research Network - Data Coordination Center, Observation Study of Persons with Chronic Hepatitis B Virus infection in North America, G3119897112, Institute of Translational Health Sciences, North Carolina Translational & Clinical Sciences Institute (NC TraCS), Harvard Hepatitis B Consortium, Michigan Institute for Clinical and Health Research (MICHR) (UL1), Center for Clinical and Translational Research, GENERAL CLINICAL RESEARCH CENTER, Immune regulation and co-stimulation in treatment outcome of chronic hepatitis B, Center for Clinical and Translational Research, Clinical and Translational Science Institute, Midwest Hepatitis B Consortium, North Carolina Hepatitis B Research Network, HBV Research Network Database Protocol and Clinical Trial Study Proposals, Optimal Long-term Outcome of Chronic Hepatitis B, Hepatitis Beta Research Network Clinical Center in Pacific Northwest/Alaska, Center for Molecular Studies in Digestive and Liver Diseases, Hepatitis B Clinical Research Network Clinical Center: Michigan - Hawaii Consortium
OpenAlex ID: W3155340861