Impact of fatty liver on hepatitis B virus replication and virologic response to tenofovir and entecavir

Ceylan, Bahadır; Arslan, Ferhat; Batırel, Ayşe; Fincancı, Muzaffer; Yardımcı, Cem; Fersan, Esra; Paşaoğlu, Esra; Yılmaz, Mesut; Mert, Ali

doi:10.5152/tjg.2015.150348

Cited by 38 publications

(36 citation statements)

References 27 publications

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“…This strength is especially relevant when compared to earlier studies which consisted of small samples sizes where the largest study had only 76 CHB‐NAFLD patients and the longest follow‐up was only 96 weeks with the majority having a follow‐up period of less than a year 15,16,26‐28 . Thus, our findings provide stronger evidence that neither NAFLD nor its related metabolic features influence treatment outcomes 18,29 . In fact, we found the traditional risk factors for failure of treatment remained in this study, which were high levels of HBV DNA and lower levels of ALT at baseline positivity which predicted failure to achieve either BR.…”

Section: Discussionmentioning

confidence: 52%

“…Two prior studies reported that CHB patients with hepatic steatosis as compared to those without hepatic steatosis had lower rates of HBV DNA clearance and ALT normalisation and/or delayed biochemical response in response to antiviral therapies 15,16 . However, other prior studies did not observe impact by NAFLD on long‐term biochemical or virological response over the long‐term 17,18 …”

Section: Introductionmentioning

confidence: 99%

“…Current literature reports the steatosis prevalence rate in patients with HBV ranges from 14% to 70% 7‐14 . However, data comparing treatment outcomes in CHB patients with and without concomitant NAFLD are limited because of small sample sizes and/or conflicting results 15‐18 . Two prior studies reported that CHB patients with hepatic steatosis as compared to those without hepatic steatosis had lower rates of HBV DNA clearance and ALT normalisation and/or delayed biochemical response in response to antiviral therapies 15,16 .…”

Section: Introductionmentioning

confidence: 99%

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Fatty liver is not independently associated with the rates of complete response to oral antiviral therapy in chronic hepatitis B patients

Chaung

et al. 2020

Liver International

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Background & aims Nonalcoholic fatty liver disease (NAFLD) and chronic hepatitis B (CHB) are common liver diseases. Concurrent NAFLD may affect antiviral treatment outcomes in CHB patients. The aim of this study is to investigate the impact of NAFLD on complete viral suppression ([CVS], HBV DNA <20‐100 IU/mL) and/or biochemical response ([BR], ALT of ≤25 U/L for females; 35 U/L for males) in CHB patients who received oral antiviral therapy. Methods A retrospective study of 555 treated CHB patients (187 NAFLD; 368 non‐NAFLD) from 2000 to 2016 at a USA medical centre. NAFLD was diagnosed by imaging and/or histology after ruling out secondary causes of hepatic steatosis. Results The majority of patients were male (60.7%), Asian (87.56%) and HBeAg‐negative (66.7%). NAFLD patients compared to non‐NAFLD were more likely HBeAg negative (74.3% vs 62.8%, P = .02), hypertensive (33.2% vs 22.8%, P = .009) and male (67.4% vs 57.3%, P = .02) with a higher mean BMI (25.4 ± 4.3 vs 23.8 ± 4.0 kg/m2, P < .001). Both cohorts achieved similar rates of CVS (86% vs 88%) and BR (38% vs 41%) during the follow‐up of up to 60 months (P > .05), but NAFLD had higher cumulative rates of CVS + BR, compared with non‐NAFLD patients (32.5% vs 22.8%, P = .03). In multivariate analyses, NAFLD was not independently associated with CVS and/or BR outcomes. Receipt of entecavir or tenofovir (vs older therapies) and lower baseline HBV DNA or higher ALT were positively associated with achieving CVS or BR. Conclusion Concomitant NAFLD had no impact on the long‐term rates of CVS and/or BR in treated CHB patients.

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Section: Discussionmentioning

confidence: 52%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Fatty liver is not independently associated with the rates of complete response to oral antiviral therapy in chronic hepatitis B patients

Chaung

et al. 2020

Liver International

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“…Although, it should be pointed out that their study observed a higher sustained virologic response in the non Hepatic Steatosis group. Another more recent study performed in Turkey by Ceylan et al (26), they found that although serum HBV DNA levels were found to be lower in patients with hepatic steatosis, the presence of hepatic steatosis has no effect on virologic response to either tenofovir or entecavir at 6 or 12 months. Interestingly, they also found that the presence of steatohepatitis may predict a favourable response in the tenofovir arm at 6 months.…”

Section: Hepatic Steatosis Hepatitis B and Virologic Response To Trementioning

confidence: 91%

Hepatitis B and concomitant hepatic steatosis

Lim

Kumar

2017

J. Thorac. Dis.

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Hepatic steatosis is becoming more common in Asia with prevalence becoming as common as Western countries. Concomitant Hepatitis B and hepatic steatosis is increasingly encountered in clinical practice. The interaction between the two concomitant conditions at both molecular level and clinical outcome remains to be explored. The present review is aimed at summarizing the existing literature on the complex interaction of the twoconcomitant disease.

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“…Not surprisingly, patients with NAFLD are at a high risk of developing metabolic complications, which may be much higher than the risk of developing liver cirrhosis 3. However, a recent study17 in Turkey found that virologic replication decreases in CHB patients in the presence of NAFLD, and NAFLD had no impact on the virologic response to entecavir along with tenofovir treatment. Therefore, in the present study, we analyzed the effect of NAFLD on the response to antiviral therapy of CHB through a retrospective clinical analysis and explored the relationship between the differences in response to therapy and insulin resistance index.…”

Section: Introductionmentioning

confidence: 99%

The effects of the insulin resistance index on the virologic response to entecavir in patients with HBeAg-positive chronic hepatitis B and nonalcoholic fatty liver disease

Zhu¹,

Wang²,

Wei³

et al. 2016

DDDT

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PurposeTo further observe and verify the effect of nonalcoholic fatty liver disease (NAFLD) on the response to antiviral therapy in patients with chronic hepatitis B (CHB) and investigate the relationship between the virologic response and insulin resistance.Patients and methodsA retrospective study was adopted and 61 NAFLD patients with HBeAg-positive CHB were included as the observation group (group A), and 64 patients with simple CHB were included as the control group (group B).ResultsAfter 12 weeks of treatment with entecavir, the total virologic response rate in group A was statistically significantly lower than that in group B (P<0.05). During weeks 24–96, the difference was not statistically significant (P>0.05). In weeks 48 and 96, there was no significant difference in the HBeAg seroconversion rates between the two groups (P>0.05). In weeks 12 and 24, there was also no significant difference in the alanine transaminase (ALT) normalization rate between the two groups (P>0.05). Then, in weeks 48 and 96, the ALT normalization rate of group A was obviously lower than that of group B (P<0.05). Group A patients were divided into group A1 (≤M) and group A2 (>M) according to the median value (M=2.79) of the baseline homeostatic model assessment method insulin resistance levels. In weeks 48 and 96, the ALT normalization rate of group A1 was significantly higher than that of group A2 (P<0.05). The correlation coefficient (r) of the baseline homeostatic model assessment method insulin resistance level and the severity of fatty liver in group A was 0.426 (P=0.001).ConclusionNAFLD cannot affect the long-term total virologic response rate and HBeAg seroconversion rate in CHB patients treated with entecavir but can reduce the long-term biochemical response rate, which has a positive correlation with the severity of fatty liver and the insulin resistance index.

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Impact of fatty liver on hepatitis B virus replication and virologic response to tenofovir and entecavir

Cited by 38 publications

References 27 publications

Fatty liver is not independently associated with the rates of complete response to oral antiviral therapy in chronic hepatitis B patients

Fatty liver is not independently associated with the rates of complete response to oral antiviral therapy in chronic hepatitis B patients

Hepatitis B and concomitant hepatic steatosis

The effects of the insulin resistance index on the virologic response to entecavir in patients with HBeAg-positive chronic hepatitis B and nonalcoholic fatty liver disease

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