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Article: Diverse effects of hepatic steatosis on fibrosis progression and functional cure in virologically quiescent chronic hepatitis B

TitleDiverse effects of hepatic steatosis on fibrosis progression and functional cure in virologically quiescent chronic hepatitis B
Authors
KeywordsHBV
NAFLD
liver stiffness
functional cure
VCTE
Issue Date2020
PublisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/jhep
Citation
Journal of Hepatology, 2020, Epub 2020-06-02 How to Cite?
AbstractBackground: Concomitant non-alcoholic fatty liver disease is common in patients with chronic hepatitis B (CHB) infection, although its impact on liver-related outcomes remains controversial. We aimed to study the effect of hepatic steatosis on risk of fibrosis progression and hepatitis B surface antigen (HBsAg) seroclearance. Methods: Treatment-naive CHB patients with normal alanine aminotransferase and low viremia (serum HBV DNA <2000 IU/mL) were prospectively recruited for baseline and 3-year transient elastography assessment. Fibrosis staging was defined according to the EASL-ALEH guidelines, with fibrosis progression defined as ≥1 stage increment of fibrosis. Hepatic steatosis and severe hepatic steatosis were defined as controlled attenuation parameter (CAP) ≥248 dB/m & ≥280 dB/m respectively. Results: 330 patients (median age 50.5 years, 41.2% male, median HBV DNA 189 IU/mL) were recruited. Twenty-two patients (6.7%) achieved HBsAg seroclearance during follow-up, and the presence of hepatic steatosis was associated with significantly higher chance of HBsAg seroclearance (hazard ratio: 3.246, 95%CI 1.278–8.243, p=0.013). At baseline, 48.8% and 28.8% had steatosis and severe steatosis, respectively. 4.2% had F3/F4 at baseline, which increased to 8.7% at 3 years. The rate of liver fibrosis progression in patients with persistent severe steatosis was higher than those without steatosis (41.3% vs. 23%, p=0.05). Persistent severe hepatic steatosis was independently associated with fibrosis progression (odds ratio: 2.379, 95%CI 1.231–4.597, p=0.01). Conclusions: CAP measurements have predictive values in virologically quiescent CHB patients. Presence of hepatic steatosis was associated with a higher risk of fibrosis progression but paradoxically a 3-fold increase in HBsAg seroclearance rate.
Persistent Identifierhttp://hdl.handle.net/10722/283050
ISSN
2023 Impact Factor: 26.8
2023 SCImago Journal Rankings: 9.857
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorMak, LY-
dc.contributor.authorHui, RWH-
dc.contributor.authorFung, J-
dc.contributor.authorLIU, F-
dc.contributor.authorWong, DKH-
dc.contributor.authorCheung, KS-
dc.contributor.authorYuen, MF-
dc.contributor.authorSeto, WK-
dc.date.accessioned2020-06-05T06:24:23Z-
dc.date.available2020-06-05T06:24:23Z-
dc.date.issued2020-
dc.identifier.citationJournal of Hepatology, 2020, Epub 2020-06-02-
dc.identifier.issn0168-8278-
dc.identifier.urihttp://hdl.handle.net/10722/283050-
dc.description.abstractBackground: Concomitant non-alcoholic fatty liver disease is common in patients with chronic hepatitis B (CHB) infection, although its impact on liver-related outcomes remains controversial. We aimed to study the effect of hepatic steatosis on risk of fibrosis progression and hepatitis B surface antigen (HBsAg) seroclearance. Methods: Treatment-naive CHB patients with normal alanine aminotransferase and low viremia (serum HBV DNA <2000 IU/mL) were prospectively recruited for baseline and 3-year transient elastography assessment. Fibrosis staging was defined according to the EASL-ALEH guidelines, with fibrosis progression defined as ≥1 stage increment of fibrosis. Hepatic steatosis and severe hepatic steatosis were defined as controlled attenuation parameter (CAP) ≥248 dB/m & ≥280 dB/m respectively. Results: 330 patients (median age 50.5 years, 41.2% male, median HBV DNA 189 IU/mL) were recruited. Twenty-two patients (6.7%) achieved HBsAg seroclearance during follow-up, and the presence of hepatic steatosis was associated with significantly higher chance of HBsAg seroclearance (hazard ratio: 3.246, 95%CI 1.278–8.243, p=0.013). At baseline, 48.8% and 28.8% had steatosis and severe steatosis, respectively. 4.2% had F3/F4 at baseline, which increased to 8.7% at 3 years. The rate of liver fibrosis progression in patients with persistent severe steatosis was higher than those without steatosis (41.3% vs. 23%, p=0.05). Persistent severe hepatic steatosis was independently associated with fibrosis progression (odds ratio: 2.379, 95%CI 1.231–4.597, p=0.01). Conclusions: CAP measurements have predictive values in virologically quiescent CHB patients. Presence of hepatic steatosis was associated with a higher risk of fibrosis progression but paradoxically a 3-fold increase in HBsAg seroclearance rate.-
dc.languageeng-
dc.publisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/jhep-
dc.relation.ispartofJournal of Hepatology-
dc.subjectHBV-
dc.subjectNAFLD-
dc.subjectliver stiffness-
dc.subjectfunctional cure-
dc.subjectVCTE-
dc.titleDiverse effects of hepatic steatosis on fibrosis progression and functional cure in virologically quiescent chronic hepatitis B-
dc.typeArticle-
dc.identifier.emailMak, LY: lungyi@HKUCC-COM.hku.hk-
dc.identifier.emailFung, J: jfung@hkucc.hku.hk-
dc.identifier.emailWong, DKH: danywong@hku.hk-
dc.identifier.emailCheung, KS: cks634@hku.hk-
dc.identifier.emailYuen, MF: mfyuen@hku.hk-
dc.identifier.emailSeto, WK: wkseto@hku.hk-
dc.identifier.authorityMak, LY=rp02668-
dc.identifier.authorityFung, J=rp00518-
dc.identifier.authorityWong, DKH=rp00492-
dc.identifier.authorityCheung, KS=rp02532-
dc.identifier.authorityYuen, MF=rp00479-
dc.identifier.authoritySeto, WK=rp01659-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.jhep.2020.05.040-
dc.identifier.pmid32504663-
dc.identifier.scopuseid_2-s2.0-85088560138-
dc.identifier.hkuros310297-
dc.identifier.volumeEpub 2020-06-02-
dc.identifier.isiWOS:000572079900015-
dc.publisher.placeNetherlands-
dc.identifier.issnl0168-8278-

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