Increased Risk of Liver-Related Outcomes in Chronic Hepatitis B Patients with Metabolic Syndrome: A Systematic Review and Meta-Analysis

Thin, Khin Naing; Tran, Andrew; Li, Jie; Lee, Eunice Yewon; Yang, Hongli; Rui, Fajuan; Liu, Chuanli; Stave, Christopher D; Cheung, Ramsey; Nguyen, Mindie H.

doi:10.1159/000521768

Cited by 5 publications

(2 citation statements)

References 41 publications

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“…Our analysis was limited by the missingness of certain data. For example, we were unable to adjust for metabolic laboratory parameters such as total cholesterol, triglycerides and glucose, although emerging evidence suggests the combination of metabolic disease and CHB can accelerate the progression of liver pathology (35,36). As body mass index and alcohol were missing for majority of the study subjects in this study, we were unable to consider these risk factors in the analysis for the development of liver fibrosis and cirrhosis.…”

Section: Discussionmentioning

confidence: 99%

Classification of virologic trajectories during nucleos/tide analogue treatment of hepatitis B virus (HBV) infection

Wang,

Campbell,

Stockdale

et al. 2023

Preprint

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Background & AimsThe dynamics of HBV viral load (VL) in patients with chronic hepatitis B (CHB) on nucleos/tide analogue (NA) treatment and its relationship with liver disease are poorly understood. We aimed to study longitudinal VL patterns and their associations with CHB clinical outcomes.MethodsUtilising large scale, routinely collected electronic health records from six centres in England, collated by the National Institute for Health and Care Research Health Informatics Collaborative (NIHR HIC), we applied latent class mixed models to investigate VL trajectory patterns in adults receiving NA treatment. We assessed associations of VL trajectory with alanine transaminase (ALT), and with liver fibrosis/cirrhosis.ResultsWe retrieved data from 1885 adults on NA treatment (median follow-up 6.2 years, interquartile range (IQR) 3.7-9.3 years), with 21,691 VL measurements (median 10 per patient, IQR 5-17). Five VL classes were identified from the derivation cohort (n=1367, discrimination: 0.93, entropy: 0.90): class 1 ‘long term suppression’ (n=827, 60.5%), class 2 ‘timely virological suppression’ (n=254, 18.6%), class 3 ‘persistent moderate viraemia’ (n=140, 10.2%), class 4 ‘persistent high-level viraemia’ (n=44, 3.2%), and class 5 ‘slow virological suppression’ (n=102, 7.5%). The model demonstrated a discrimination of 0.93 and entropy of 0.88 for the validation cohort (n=518). ALT decreased variably over time in VL-suppressed groups (classes 1, 2, 5; all p<0.001), but did not significantly improve in those with persistent viraemia (classes 3, 4). Patients in class 5 had 2-fold increased hazards of fibrosis/cirrhosis compared to class 1 (adjusted hazard ratio, 2.00; 95% CI, 1.33-3.02).ConclusionsHeterogeneity exists in virological response to NA therapy in CHB patients, with over 20% showing potentially suboptimal responses. Slow virological suppression is associated with liver disease progression.

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Section: Discussionmentioning

confidence: 99%

Classification of virologic trajectories during nucleos/tide analogue treatment of hepatitis B virus (HBV) infection

Wang,

Campbell,

Stockdale

et al. 2023

Preprint

View full text Add to dashboard Cite

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“… 2 Furthermore, the co-existence of these diseases is associated with more frequent and severe adverse clinical events such as liver fibrosis than HS or CHB alone. 3 There is a need for reliable diagnostic methods to detect and manage this condition in affected individuals. It should be noted that histologic evaluation via liver biopsy remains the gold standard to diagnose advanced fibrosis in patients with chronic liver diseases.…”

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confidence: 99%

A Novel Algorithm for Streamlining Diagnosis of Advanced Liver Fibrosis in CHB Patients with Concurrent Hepatic Steatosis

Xu,

Rui,

et al. 2024

J Clin Transl Hepatol

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Liver fibrosis is closely linked with metabolic-associated diseases in patients with autoimmune hepatitis

Liu,

Feng,

Chi

et al. 2024

Hepatol Int

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Background This cross-sectional study aimed to investigate the impact of metabolic-associated diseases (MADs) on patients with autoimmune hepatitis (AIH). Methods The study analyzed the clinical characteristics of 283 AIH patients who underwent liver biopsy between January 2016 and February 2022 in Ruijin Hospital, Shanghai, China. Results Among the identified AIH patients (n = 283), 87.3%, 23.0%, or 43.1% had MADs, non-alcoholic fatty liver disease (NAFLD), or severe fibrosis, respectively. The proportion of diabetes mellitus (DM) was significantly higher in patients with severe liver fibrosis than in those with mild or moderate fibrosis in the AIH cohort (31.1% vs. 18.0%, p < 0.05). Fibrosis was also more severe in patients with NAFLD than in those without (53.8% vs. 39.9%, p < 0.05). Age, Plts, IgG and the presence with MADs were identified as independent predictors of the severity of inflammation in AIH patients. Moreover, severe liver fibrosis (stages 3 to 4) was independently associated with male (OR, 2.855; p = 0.025), γ-GT (OR, 0.997; p = 0.007), and combination with MADs (OR, 4.917; p = 0.006). Furthermore, combination with DM was also an independent predictor of severe liver fibrosis in AIH patients (OR, 2.445, p = 0.038). Conclusions Concurrent MADs, common in AIH patients, is an independent risk factor for severe fibrosis or inflammation; of note, combination with DM was also an independent predictor of severe liver fibrosis in AIH patients. While managing with AIH, routine assessment of co-existing MADs, especially DM, is also important.

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Increased Risk of Liver-Related Outcomes in Chronic Hepatitis B Patients with Metabolic Syndrome: A Systematic Review and Meta-Analysis

Cited by 5 publications

References 41 publications

Classification of virologic trajectories during nucleos/tide analogue treatment of hepatitis B virus (HBV) infection

Classification of virologic trajectories during nucleos/tide analogue treatment of hepatitis B virus (HBV) infection

A Novel Algorithm for Streamlining Diagnosis of Advanced Liver Fibrosis in CHB Patients with Concurrent Hepatic Steatosis

Liver fibrosis is closely linked with metabolic-associated diseases in patients with autoimmune hepatitis

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