Hepatic Steatosis Index in the Detection of Fatty Liver in Patients with Chronic Hepatitis B Receiving Antiviral Therapy

Abstract

Background/Aims: The hepatic steatosis index (HSI) is a noninvasive method to assess the severity of hepatic steatosis. Antiviral therapy (AVT) can impact aspartate aminotransferase and alanine aminotransferase levels, which are the main components of the HSI. Thus, we investigated the accuracy of the HSI in detecting hepatic steatosis in patients with chronic hepatitis B (CHB) receiving AVT, compared with those not receiving AVT and in those with nonalcoholic fatty liver disease (NAFLD). Methods: Patients with CHB or NAFLD who underwent a magnetic resonance imaging proton density fat fraction (MRI-PDFF) evaluation between March 2010 and March 2019 were recruited. Hepatic steatosis was diagnosed when the PDFF exceeded 5%. Area under the receiver operating characteristic curve (AUROC) analysis was used to assess the diagnostic accuracy of the HSI in the detection of hepatic steatosis. Results: The mean age of the study population (189 men and 116 women; 244 with CHB [184 with and 60 without AVT] and 61 with NAFLD) was 55.6 years. The AUROC values for detecting hepatic steatosis were similar between patients with CHB (0.727; p<0.001) and those with NAFLD (0.739; p=0.002). However, when patients with CHB were subdivided into those receiving and not receiving AVT, the AUROC value decreased slightly in patients with CHB receiving AVT compared to those without not receiving AVT (0.707; p=0.001 vs 0.779; p=0.001). Conclusions: Despite a slight attenuation, the diagnostic accuracy of the HSI in patients with CHB receiving AVT in detecting hepatic steatosis was still acceptable. Further large-scale studies are required for validation.

Clinical Features of Patients With COVID‐19 With Nonalcoholic Fatty Liver Disease

“…However, HSI was proposed by Lee et al (12) as a diagnostic tool for NAFLD and has been validated by several studies with acceptable diagnostic accuracy. (25)(26)(27) Due to the emergency situation, liver histology and/or radiologically for the diagnosis of NAFLD was not available in our study. Although liver histology is considered to be the gold standard for the diagnosis of NAFLD, it cannot be conducted on the general population or for patients with COVID-19.…”

KASL clinical practice guidelines: Management of nonalcoholic fatty liver disease

“…The HSI showed acceptable accuracy among a Korean population. 132 The noninvasive surrogates just described show acceptable accuracy in most cross-section studies and have been used to trace changes in hepatic steatosis in certain studies. However, the usefulness of those noninvasive surrogates in monitoring disease progression and evaluating treatment response should be further investigated.…”

Anti-inflammatory diet consumption reduced fatty liver indices: Finding from a large cohort study in the Kurdish population

“…Recently, a number of indices have been considered to predict fatty changes of the liver including the fatty liver index (FLI), hepatic steatosis index (HIS) and NASH Score, and Steato test (ST) [14][15][16]. FLI developed by Bedogni et al in 2006, is an equation includes body mass index (BMI), waist circumference (WC), triglycerides (TG), and Gamma-Gluteamyl transferase (GGT) to predict fatty liver [14], that is easy to use because each of its components is a common clinical measurement, this index has been validated as a practical, reliable and economical tool for diagnosing NAFLD in large epidemiological studies [17].…”