Severe Hepatic Steatosis Is Associated With Low-Level Viremia and Advanced Fibrosis in Patients With Chronic Hepatitis B in North America

The obesity epidemic has increased the risk of nonalcoholic fatty liver disease (NAFLD) in both the general and chronic hepatitis B (CHB) populations. Our study aims to determine the prevalence of NAFLD in patients with CHB based on controlled attenuation parameter (CAP) and the epidemiological, cli...

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Bibliographic Details
Published in:Gastro hep advances 2022, Vol.1 (1), p.106-116
Main Authors: Ko, Hin Hin, Patel, Nishi H., Haylock-Jacobs, Sarah, Doucette, Karen, Ma, Mang M., Cooper, Curtis, Kelly, Erin, Elkhashab, Magdy, Tam, Edward, Bailey, Robert, Wong, Alexander, Minuk, Gerald, Wong, Philip, Fung, Scott K., Sebastiani, Giada, Ramji, Alnoor, Coffin, Carla S.
Format: Article
Language:English
Subjects:
Controlled Attenuated Parameter (CAP)
Fatty Liver Disease
Hepatic Steatosis
Hepatitis B
Transient Elastography (TE)
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Summary:The obesity epidemic has increased the risk of nonalcoholic fatty liver disease (NAFLD) in both the general and chronic hepatitis B (CHB) populations. Our study aims to determine the prevalence of NAFLD in patients with CHB based on controlled attenuation parameter (CAP) and the epidemiological, clinical, and virological factors associated with severe hepatic steatosis. The Canadian Hepatitis B Network cohort was utilized to provide a cross-sectional description of demographics, comorbidities, antiviral treatment, and hepatits B virus (HBV) tests. Liver fibrosis and steatosis were measured by transient elastography and CAP, respectively. Any grade and severe steatosis were defined as CAP >248 and >280 dB/m, respectively. Advanced liver fibrosis was defined as transient elastography measurement >10.7 kPa. In 1178 patients with CHB (median age: 47.4%, 57.7% males, 75.7% Asian, 13% African, 6.5% White, 86% HBV e antigen negative, median HBV DNA of 2.44 log10IU/mL, 42.7% receiving treatment), the prevalence of any grade and severe steatosis was 53% and 36%, respectively. In the multivariate analysis, obesity was a significant predictor for severe steatosis (adjusted odds ratio: 5.046, 95% confidence interval: 1.22–20.93). Severe steatosis was a determinant associated with viral load (adjusted odds ratio: 0.385, 95% confidence interval: 0.20–0.75, P 
ISSN:2772-5723
2772-5723
DOI:10.1016/j.gastha.2021.09.005