No influence of hepatic steatosis on the 3-year outcomes of patients with quiescent chronic hepatitis B.

Abstract

The influence of hepatic steatosis on the natural history of chronic hepatitis B (CHB) virus is unclear. Therefore, we investigated whether concurrent steatosis in patients with CHB influences the probability of hepatitis B surface antigen (HBsAg) loss, fibrosis progression and hepatocellular carcinoma (HCC) development. This study enrolled treatment-naïve patients with virologically (HBV DNA <2,000IU/ml) and biochemically (alanine aminotransferase level <40IU/L) quiescent CHB who underwent transient elastography between January 2004 and December 2015 and completed 3years of follow-up. RESULTS: The mean age of the study population (n=720) was 52.0years, and there were more men than women (n=419, 58.2%). The mean HBV DNA level was 321.6IU/ml. During the 3-year period, 74 (10.3%) patients achieved HBsAg seroclearance. Lower HBV DNA levels (hazard ratio=0.995, p<.05) were independently associated with HBsAg seroclearance, while hepatic steatosis was not (p>.05). Fibrosis progressed in 89 (12.4%) patients. Male gender (odds ratio [OR]=1.720) and higher body mass index (OR=1.083) were independently associated with an increased probability of fibrosis progression (all p<.05), while higher total cholesterol levels (OR=0.991) and higher liver stiffness values (OR=0.862) were independently associated with a decreased probability of fibrosis progression (all p<.05). HCC developed in 46 (6.4%) patients. Male gender (OR=3.917) and higher AST levels (OR=1.036) were independently associated with an increased probability of HCC development (p<.05). Hepatic steatosis was not associated with the probability of HBsAg seroclearance, fibrosis progression or HCC development in patients quiescent CHB in our study. Further studies with longer follow-up periods are required to validate our findings.