Abstract
Objective To investigate the relationship between hepatic steatosis and virological markers in patients with chronic hepatitis B (CHB) during immune clearance (IC) phase. Methods Pathology proven CHB patients in IC phase were collected from the Liver Center of the First Affiliated Hospital of Fujian Medical University from January 2009 to October 2016. Patients were divided into non-to mild fatty liver (F0-F1) group and moderate to severe fatty liver (F2-F4) group according to the liver steatosis degree. The relationship between liver steatosis and virological markers in serum was compared. The measurement data were analyzed using independent sample t test, and the count data were analyzed by chi-square test. Results A total of 298 patients were included, including 237 males (79.5%) and 61(20.5%) females, and the average age was (32.4±10.3) years old. The 23.5% (70/298) of these patients had liver steatosis. A total of 273 (91.6%) cases were in F0-F1 group, and the remaining 25 (8.4%) cases were in F2-F4 group. The patients in F2-F4 group had higher body mass index ([25.90±2.70] vs [21.68±2.90] kg/m2), serum triglyceride ([1.52±0.77] vs [1.11±0.55] mmol/L) and cholesterol ([4.88±1.15] vs [4.33±0.92] mmol/L) than F0-F1 group, and the differences were all statistically significant (t=-7.007, -2.667, and -2.751, respectively, all P<0.05). In addition, the serum levels of HBsAg and HBV DNA in F2-F4 group were also significantly higher than F0-F1 group (t=-3.291 and -2.831, respectivelt, both P<0.01). According to the grading of inflammation and fibrosis, the differences of HBsAg and HBV DNA levels between F0-F1 group and F2-F4 group were statistically significant only in patients with more severe inflammation (t=-2.738 and -2.135, respectively, both P<0.05) or less severe fibrosis (t=-2.258 and -2.333, respectively, both P<0.05). Conclusion Among CHB patients experiencing immune clearance, serum HBsAg and HBV DNA levels are positively correlated with the severity of hepatic steatosis, and this phenomenon is closely related to the degree of liver inflammation. Key words: Hepatitis B, chronic; Hepatitis B surface antigens; Fatty liver; Immune clearance
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