The Effect of Hepatosteatosis on Response to Antiviral Treatment in Patients with Chronic Hepatitis B: A Meta-Analysis

Zhu, Yunqing; Yang, Qiao; Lv, Fangfang; Yu, Yunsong

doi:10.1155/2017/1096406

Cited by 20 publications

(22 citation statements)

References 24 publications

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“…A nested case‐control study in 267 entecavir‐treated patients with CHB found that hepatic steatosis was significantly associated with nonresponse to entecavir . Similarly, a meta‐analysis based on eight prospective cohort studies also suggested that hepatic steatosis could lower the efficacy of antiviral treatment (especially NAs) in patients with CHB . Although the impact of hepatic steatosis on antiviral therapy in these patients remains debatable, the onset or progression of NAFLD during antiviral therapy is still recommended to be monitored in case of underlying negative impacts.…”

Section: Potential Interplay Between Hepatic Steatosis and Antiviral mentioning

confidence: 99%

Chronic hepatitis B and non‐alcoholic fatty liver disease: Conspirators or competitors?

Zhang

Lin

Jiang

et al. 2020

Liver International

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Despite the widespread use of vaccines and antiviral drugs, approximately 350‐400 million patients with chronic hepatitis B (CHB) remain worldwide, who carry high risk of cirrhosis and liver carcinoma. Moreover, owing to improvements in global living standards and lifestyle changes, non‐alcoholic fatty liver disease (NAFLD) has become the most common chronic liver disease. Coexistence of NAFLD and CHB is commonly observed, especially in Asian CHB populations; however, little is known regarding the relationship between these two diseases as comorbidities. In this review, we summarize recent advances in clinical and basic researches related to the underlying mutual interactions, as well as potential animal models to facilitate further investigation.

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Section: Potential Interplay Between Hepatic Steatosis and Antiviral mentioning

confidence: 99%

Chronic hepatitis B and non‐alcoholic fatty liver disease: Conspirators or competitors?

Zhang

Lin

Jiang

et al. 2020

Liver International

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“…Although NAFLD/HS itself is a major cause of CLD [4,5], it can also develop in patients who already have various CLDs. HS is reported to be a major factor causing ALT elevation in HBV-infected patients with a low viral load [6,7], and a meta-analysis suggested that the presence of HS may influence the efficacy of antiviral therapy, especially in nucleotide/nucleoside analogue (NA) treatment; this effect is less commonly observed in patients undergoing pegylated-interferon (PEG-IFN) treatment [8].…”

Section: Introductionmentioning

confidence: 99%

Possible Relevance of PNPLA3 and TLL1 Gene Polymorphisms to the Efficacy of PEG-IFN Therapy for HBV-Infected Patients

Enomoto

Aizawa

Hasegawa

et al. 2020

IJMS

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Lifestyle changes have led to an increase in the number of patients with nonalcoholic fatty liver disease (NAFLD). However, the effects of NAFLD-associated single-nucleotide gene polymorphisms (SNPs) in HBV-infected patients have not been adequately investigated. Methods: We investigated the association of the NAFLD-related SNPs patatin-like phospholipase domain-containing protein 3 (PNPLA3; rs738409), transmembrane 6 superfamily member 2 (TM6SF2; rs58542926), 17-beta hydroxysteroid dehydrogenase 13 (HSD17B13; rs72613567, rs6834314 and rs62305723), membrane-bound O-acyltransferase domain containing 7 (MBOAT7; rs641738) and glucokinase regulatory protein (GCKR; rs1260326) with the presence of histologically proven hepatic steatosis (HS) in HBV-infected patients (n = 224). We also investigated tolloid-like 1 (TLL1) SNP (rs17047200), which has been reported to be involved in the disease progression in Japanese NAFLD patients, and evaluated the association of HS and various SNPs with the treatment efficacy of pegylated-interferon (PEG-IFN) monotherapy following nucleotide/nucleoside (NA) treatment (NA/PEG-IFN sequential therapy; n = 64). Among NAFLD-associated SNPs evaluated, only the PNPLA3 SNP was significantly associated with the presence of hepatic steatosis in a total of 224 HBV-infected patients (P = 1.0 × 10−4). Regarding the sequential therapy, PNPLA3 SNP and TLL1 SNP were related to the treatment efficacy, and patients without minor alleles of these SNPs showed favorable results with a high virologic response and significant reduction in their HBsAg titer. A multivariate analysis showed that HBeAg positivity (odds ratio 5.810, p = 0.016) and the absence of a risk allele in PNPLA3 and TLL1 SNPs (odds ratio 8.664, p = 0.0042) were significantly associated with treatment efficacy. The PNPLA3 SNP might be associated with the presence of HS, and the combination of the PNPLA3 and TLL1 SNPs might be related to the efficacy of PEG-IFN monotherapy following NA treatment.

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“…If a liver biopsy is not performed and antiviral treatment is only based on a transaminase abnormality, the 33.3% of patients may be treated using the wrong regimen. Our results explained that if only a transaminase abnormality is used as the indication for antiviral treatment in CHB and NAFLD coexistent patients, some chronic inflammation caused by NAFLD may be wrongly treated by antiviral therapy, resulting in poor response [1].…”

Section: Discussionmentioning

confidence: 81%

“…Hepatitis B virus (HBV) infection is one of the major causes of chronic liver disease, which ranges from chronic hepatitis to liver cirrhosis and even hepatocellular carcinoma [1,2]. It is estimated that HBV infection afflicts approximately 240 million patients with chronic hepatitis B (CHB) worldwide [3].…”

Section: Introductionmentioning

confidence: 99%

“…In CHB patients with NAFLD, chronic hepatitis may be caused by CHB, NAFLD, or both [12,13]. A clinical study of antiviral therapy in CHB patients with NAFLD found that when NAFLD patients were diagnosed with liver biopsy and treated with interferon, NAFLD did not affect the efficacy of antiviral therapy, whereas when NAFLD patients were diagnosed with Doppler ultrasound and treated with nucleoside analogues, NAFLD affected the efficacy of antiviral therapy, resulting in poor biochemical and virological response [1]. What causes the difference in the treatment outcome, the antiviral treatment regimen (interferon vs. nucleoside analogues), or the different methods assessing chronic inflammation (liver biopsy vs. alanine aminotransferase (ALT) and Doppler ultrasound) remains unclear.…”

Section: Introductionmentioning

confidence: 99%

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Interface Hepatitis over Grade 2 May Differentiate Chronic Inflammation Associated with CHB from NAFLD in the Early Stage

Zhu

Wang

Fang

et al. 2020

Gastroenterology Research and Practice

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Background. Patients with chronic hepatitis B (CHB) concomitant with nonalcoholic fatty liver disease (NAFLD) are increasing. Objectives. To identify pathological features that can be used to differentiate between chronic inflammation caused by CHB and that caused by NAFLD. Methods. Patients with CHB (n=31) needing antiviral treatment, NAFLD (n=50), or CHB-NAFLD (n=51) who underwent biopsy were retrospectively enrolled. Pathological characteristics of chronic inflammation were evaluated using the METAVIR scoring system. The rates of three pathological characteristics were first compared in patients with NAFLD and those with CHB, then compared after fibrosis matching, and were finally compared in CHB-NAFLD patients with different viral loads. Results. The rates of interface hepatitis over grade 2 and fibrosis over grade 2 were significantly higher in the CHB group than in the NAFLD group (100% vs. 4% and 80.6% vs. 22%; both P<0.0001), while no significant difference was observed in the rate of lobular inflammation over grade 2 between the two groups. After fibrosis matching, in patients with F0–2 fibrosis, the rate of interface hepatitis over grade 2 in CHB was significantly higher than that in NAFLD (100% vs. 0%; P<0.0001). In CHB-NAFLD patients with F0–2 fibrosis, the rate of interface hepatitis over grade 2 in cases with a high viral load was significantly higher than cases with a low viral load (66.6% vs. 0%; P<0.0001). The rate of lobular inflammation showed no difference between groups. Conclusion. Interface hepatitis over grade 2 can be used for the differential diagnosis of chronic inflammation associated with CHB or NAFLD in the early stage.

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The Effect of Hepatosteatosis on Response to Antiviral Treatment in Patients with Chronic Hepatitis B: A Meta-Analysis

Cited by 20 publications

References 24 publications

Chronic hepatitis B and non‐alcoholic fatty liver disease: Conspirators or competitors?

Chronic hepatitis B and non‐alcoholic fatty liver disease: Conspirators or competitors?

Possible Relevance of PNPLA3 and TLL1 Gene Polymorphisms to the Efficacy of PEG-IFN Therapy for HBV-Infected Patients

Interface Hepatitis over Grade 2 May Differentiate Chronic Inflammation Associated with CHB from NAFLD in the Early Stage

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