Abstract

The coexistence of HBV infection and hepatic steatosis is a novel characteristic of liver disease. Silibinin capsules (SC) is a silybin-phospholipid complex containing silybin as the bioactive component, which exerts a remarkable biological effect on various liver diseases, including nonalcoholic fatty liver disease (NAFLD). The purpose of this study was to investigate (1) the prevalence of hepatic steatosis in the general population and patients with chronic hepatitis B (CHB) and (2) to evaluate the effect of SC combined with therapeutic lifestyle changes (TLC) compared with TLC alone on hepatic steatosis in patients with CHB. A total of 16,451 individuals underwent transient elastography (TE) with the control attenuation parameter (CAP) measurement, among which the prevalence of hepatic steatosis was 31.1% in patients with CHB and 42.2% in the general population. The prevalence of hepatic steatosis differed between patients with CHB and the general population at an age of 40 years or older but was similar in individuals aged 39 years or younger (p < 0.05). Furthermore, in patients with CHB presenting hepatic steatosis, the post-6-month relative reduction in CAP in the SC combined with TLC group (p = 0.001) was significantly greater than in the TLC alone group (p = 0.183). The CAP distribution of different steatosis grades (S1, S2, and S3) in the SC combined with TLC group was decreased and S0 (CAP < 248 dB/m) increased significantly, but not significant in the TLC group. Thus, SC combined with TLC may effectively improve hepatic steatosis in patients with CHB.

Highlights

  • The coexistence of Hepatitis B virus (HBV) infection and hepatic steatosis is a novel characteristic of liver disease

  • A total of 16,451 subjects were recruited for this study; 5680 participants positive for the hepatitis B surface antigen (HBsAg), and 10,771 subjects negative for the HBsAg served as the general population

  • Clinical studies have reported an association between HBV infection and a lower prevalence of hepatic steatosis, metabolic syndrome and h­ ypertriglyceridemia21

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Summary

Introduction

The coexistence of HBV infection and hepatic steatosis is a novel characteristic of liver disease. Its prevalence is increasing in association with the global increase in obesity and is currently present in 20–44% of the general ­population6 Both CHB and fatty liver are common, and many patients suffer from both conditions. A novel tool based on the evaluation of ultrasound attenuation using transient elastography (TE) called control attenuation parameter (CAP) has been shown to correlate well with the histopathological steatosis ­stage7 This approach enables a noninvasive and accurate assessment of the stage of steatosis in patients with fatty ­liver. We aimed to investigate the prevalence of hepatic steatosis measured using CAP, to clarify the factors influencing the CAP level in patients with CHB, and mainly to reveal the effect of the SC therapeutic intervention on improving steatosis

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