Association Between Fatty Liver and Cirrhosis, Hepatocellular Carcinoma, and Hepatitis B Surface Antigen Seroclearance in Chronic Hepatitis B

Abstract

Background Chronic hepatitis B (CHB) and fatty liver (FL) are common, natural history data on concurrent FL and CHB (FL-CHB) are limited. This study aimed to evaluate the effect of FL on cirrhosis, hepatocellular carcinoma (HCC), and HBsAg seroclearance incidence in CHB patients. Methods In a retrospective cohort study of 6,786 adult CHB patients, we used propensity score matching (PSM) to balance the FL-CHB and non-FL CHB groups. Kaplan-Meier methods were used to compare cumulative cirrhosis, HCC, and HBsAg seroclearance rates between subgroups. Results Before PSM, compared to non-FL CHB, FL-CHB patients had lower 10-year cumulative rates of cirrhosis, HCC, and a higher HBsAg seroclearance rate. Similar results were found in the matched FL-CHB and non-FL CHB patients, as well as in antiviral treated PSM cohort. Cox proportional hazards model indicated FL to remain significantly and strongly associated with lower risk of cirrhosis and HCC (HR: 0.19, 95% CI: 0.12-0.33, P<0.001, 0.21, 95% CI: 0.09-0.51, P=0.001, respectively) in antiviral treated patients, but not in untreated patients. Conclusions FL was significantly associated with lower cirrhosis and HCC risk and higher HBsAg seroclearance. Further studies are needed to confirm our funding and investigate the mechanisms underlying the impact of FL on CHB.

Evaluation of stability and inactivation methods of SARS-CoV-2 in context of laboratory settings

“…To investigate how long SARS-CoV-2 viruses are stable in cell culture media at 4 °C, we thawed different stock aliquots of a SARS-CoV-2 (which were cryo-conserved at −80 °C, 1 × 10 8 TCID 50/ml ) at weekly intervals and stored them at 4 °C in cell culture medium for up to 160 days. Remarkably, using TCID 50 even after 160 days we were still able to detect considerable quantities of infectious virus (> 1 × 10 5 TCID 50 /ml, < 3 log reduction, data not shown), which was in line with previous findings demonstrating long-term survival under 4 °C [ 18 , 19 ].…”

Increased risk of hepatocellular carcinoma and mortality in chronic viral hepatitis with concurrent fatty liver

“…There have been a few conflicting reports regarding the long‐term prognosis of CHB patients according to the co‐existing fatty liver. While several studies have reported associations of fatty liver with advanced liver fibrosis and/or HCC development in patients with CHB, 14‐19 others have failed to demonstrate such associations 20‐24 . In contrast to CHB, the effects of fatty liver on liver fibrosis in patients with CHC have been well characterised 14,25,26 .…”

Editorial: central obesity is a risk factor for hepatocellular carcinoma in Asian patients with chronic hepatitis B on anti‐viral therapy—authors' reply

“…One recent study showed that reduced hepatic steatosis was significantly associated with a higher risk of HCC in CHB infection 9 . Additionally, in a multi‐centre retrospective cohort of 7816 Asian patients with CHB, fatty liver was significantly associated with lower risks of cirrhosis and HCC 10 . In our CHB cohort (Search‐B cohort), we also found that patients with co‐existing fatty liver had significantly lower 5‐year incidence of HCC than those without fatty liver (2.0% vs 3.4%, P = 0.004) (Figure 1).…”