Association Between Hepatic Steatosis, Measured by Controlled Attenuation Parameter, and Fibrosis Burden in Chronic Hepatitis B

Seto, Wai‐Kay; Hui, Rex Wan‐Hin; Mak, Lung‐Yi; Fung, James; Cheung, Ka‐Shing; Liu, Kevin S H; Wong, Danny Ka‐Ho; Lai, Ching–Lung

doi:10.1016/j.cgh.2017.09.044

Cited by 101 publications

(121 citation statements)

References 25 publications

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“…Another finding in the present study was the documentation of beneficial effect of NA on fibrosis regression over a very long term of follow‐up of 10 years. These were coherent with findings in other studies which had shorter durations of follow‐up compared to the current study …”

Section: Discussionsupporting

confidence: 93%

“…Liver stiffness measurement is shown to be helpful to predict these liver‐related complications . Recently, hepatic steatosis is reported as a factor associated with liver fibrosis burden in CHB patients . The association of hepatic steatosis and its confounding factors, such as the presence of metabolic syndrome, on liver fibrosis on a long‐term basis would also warrant more investigation.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Fibrosis evolution in chronic hepatitis B e antigen‐negative patients across a 10‐year interval

Mak

Seto

Hui

et al. 2019

Journal of Viral Hepatitis

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Summary The degree of liver fibrosis in chronic hepatitis B (CHB) infection influences outcome and management. Existing data describing the long‐term dynamic changes of liver fibrosis are limited. This study aimed to evaluate the evolution of liver fibrosis in CHB across a 10‐year period. CHB patients with liver stiffness measurement (LSM) by transient elastography 10 years ago were recruited for follow‐up LSM. Fibrosis stages were classified according to EASL‐ALEH guidelines. Fibrosis progression/regression was arbitrarily defined as ≥1 fibrosis stage change from baseline. A total of 459 hepatitis B e antigen (HBeAg)‐negative patients (224 untreated, 235 treated with nucleos(t)ide analogues [NAs]) were recruited. The mean age at baseline LSM was 41.7 ± 9.0 years (56.2% male). Over 10 years, the proportion of patients with advanced fibrosis/cirrhosis significantly reduced from 16.3% to 5.7% (P < 0.001). Fibrosis progression and regression were observed in 8.7% and 37.5%, respectively. No treatment with NAs (OR 2.259, 95% confidence interval [CI]: 1.032‐4.945), metabolic syndrome (OR 4.379, 95% CI: 1.128‐16.999) and hepatic steatosis (OR 7.799, 95% CI: 2.271‐26.776) was associated with fibrosis progression. Liver stiffness decline demonstrated positive correlation with the time after HBsAg seroclearance (r = −0.50, P < 0.001). Median liver stiffness was higher both at baseline (14.0 vs 6 kPa, P < 0.001) and 10 years (9.1 vs 4.9 kPa, P < 0.001) in patients with cirrhosis‐related complications/hepatocellular carcinoma compared with those without. In conclusion, CHB‐related liver fibrosis changed dynamically across 10 years. Metabolic syndrome and hepatic steatosis were associated with fibrosis progression, while antiviral therapy was associated with fibrosis regression. Patients with HBsAg seroclearance demonstrated time‐dependent decline in liver stiffness.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Fibrosis evolution in chronic hepatitis B e antigen‐negative patients across a 10‐year interval

Mak

Seto

Hui

et al. 2019

Journal of Viral Hepatitis

Self Cite

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“…We also agree that other confounding factors such as metabolic syndrome, smoking, and coffee intake should be taken into account since steatosis as a liver comorbidity is significantly associated with an increased fibrosis on the one hand and since statin use may decrease the decompensation rate in both HBV-and HCV-related cirrhosis 5 or the risk of occurrence of hepatocellular carcinoma on the other hand. 6,7 It is noteworthy that the (rare) statin use or coffee consumption were not different between the 3 groups while tobacco consumption was more frequent in HCV-monoinfected patients (64%) as compared to HBV-monoinfected (36%) (P<.001) or HCV/HBVcoinfected patients (47%) (P = .002).…”

Section: Authors' Replysupporting

confidence: 69%

“…Severe steatosis was significantly associated with increased fibrosis in both HBV-and HCVinfected patients. [5][6][7] In addition, the patients were also not evaluated for other confounding factors such as smoking, statin use and coffee intake. These factors have been demonstrated to affect the liver disease progression in HBV-or HCV-monoinfected patients.…”

mentioning

confidence: 99%

Letter: more studies are needed to elucidate the impact of HBV/HCV coinfection on cirrhosis and its consequences

Huang

Zhang

Wang

et al. 2018

Aliment Pharmacol Ther

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“…Hepatic steatosis is common both in the general population as well as patients with chronic viral hepatitis . The prevalence of non‐alcoholic fatty liver disease (NAFLD) in patients with chronic hepatitis B (CHB) ranges from 18% to 40% . Thus, LSM may be influenced by the extent of hepatic steatosis, because the shear wave must propagate through the fatty liver parenchyma.…”

mentioning

confidence: 99%

Editorial: effect of hepatic steatosis on liver stiffness in patients with chronic hepatitis B

Kim

2019

Aliment Pharmacol Ther

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Association Between Hepatic Steatosis, Measured by Controlled Attenuation Parameter, and Fibrosis Burden in Chronic Hepatitis B

Cited by 101 publications

References 25 publications

Fibrosis evolution in chronic hepatitis B e antigen‐negative patients across a 10‐year interval

Fibrosis evolution in chronic hepatitis B e antigen‐negative patients across a 10‐year interval

Letter: more studies are needed to elucidate the impact of HBV/HCV coinfection on cirrhosis and its consequences

Editorial: effect of hepatic steatosis on liver stiffness in patients with chronic hepatitis B

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