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Impact of non-alcoholic fatty liver disease on chronic hepatitis B.
Liver Int. 2007 Jun; 27(5):607-11.LI

Abstract

BACKGROUND

The impact of superimposed non-alcoholic fatty liver disease (NAFLD) is well established in patients with chronic hepatitis C (CH-C), but the impact in patients with chronic hepatitis B (CH-B) is less clear.

AIM

This study aims to evaluate the prevalence of NAFLD in patients with CH-B and the association with viral and host factors, particularly in patients with metabolic syndrome (MS).

DESIGN

Data from patients with CH-B was obtained from our databases. Patients with excessive alcohol use were excluded. Hepatitis B virus (HBV) genotyping by INNO-LIPA was available for some patients. The presence of MS was defined according to the Adult Treatment Panel III (ATP III). All biopsies were read by two hepatopathologists using Metavir, modified histologic activity index (MHAI), as well as a NAFLD pathologic protocol. Patients were classified as (1) those without NAFLD; (2) those with simple hepatic steatosis; (3) and those with superimposed non-alcoholic steatohepatitis (NASH). Factors associated with superimposed NAFLD, its subtypes, and hepatic fibrosis were also analysed.

RESULTS

Subjects included 153 HBV patients [66% male, age 50.5+/-27.5 years, body mass index 24.7+/-3.7 kg/m(2), waist 83.2+/-10.9 cm; 8.5% Caucasian, 67% Asian, aspartate aminotransferase (AST) 63.2+/-88.2 IU/l, alanine aminotransferase (ALT) 98.6+/-164.6 IU/l, glucose 111.6+/-50.5 mg/dl, HBV-DNA 1.8 x 10(8)+/-1.9 x 10(6) copies/ml, 7% with MS, 13% with diabetes, 20% with arterial hypertension and 8.5% with dyslipidaemia]. Liver biopsy was available for 64 subjects [19% had superimposed NAFLD, 13% had superimposed NASH, 86% had some degree of fibrosis, and 39% had advanced fibrosis (Ishak >3)]. Patients with HBV and superimposed NASH were significantly older (55 vs. 42 years, P=0.008), more likely to have hypertension (63% vs. 15%, P=0.006) and dyslipidaemia (50% vs. 8%, P=0.006), and had a larger waist circumference (92 vs. 83 cm, P=0.03). The presence of fibrosis was associated with higher waist circumference (84 vs. 80 cm, P=0.03), higher HBV-DNA (1.9 x 10(8) vs. 5 x 10(6) copies/ml, P=0.005), and elevated ALT >40 IU/l (73.6% vs. 33.3%, P=0.02).

CONCLUSIONS

The components of MS (obesity, hypertension, and dyslipidaemia) are associated with the presence of NASH in patients with CH-B. The presence of hepatic fibrosis seems to be associated with known host and viral factors as well as the presence of abdominal obesity.

Authors+Show Affiliations

Center for Liver Diseases at Inova Fairfax Hospital, Falls Church, VA 22003-6800, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17498244

Citation

Bondini, Silvia, et al. "Impact of Non-alcoholic Fatty Liver Disease On Chronic Hepatitis B." Liver International : Official Journal of the International Association for the Study of the Liver, vol. 27, no. 5, 2007, pp. 607-11.
Bondini S, Kallman J, Wheeler A, et al. Impact of non-alcoholic fatty liver disease on chronic hepatitis B. Liver Int. 2007;27(5):607-11.
Bondini, S., Kallman, J., Wheeler, A., Prakash, S., Gramlich, T., Jondle, D. M., & Younossi, Z. M. (2007). Impact of non-alcoholic fatty liver disease on chronic hepatitis B. Liver International : Official Journal of the International Association for the Study of the Liver, 27(5), 607-11.
Bondini S, et al. Impact of Non-alcoholic Fatty Liver Disease On Chronic Hepatitis B. Liver Int. 2007;27(5):607-11. PubMed PMID: 17498244.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of non-alcoholic fatty liver disease on chronic hepatitis B. AU - Bondini,Silvia, AU - Kallman,Jillian, AU - Wheeler,Angela, AU - Prakash,Shivaani, AU - Gramlich,Terry, AU - Jondle,Daniel M, AU - Younossi,Zobair M, PY - 2007/5/15/pubmed PY - 2007/8/19/medline PY - 2007/5/15/entrez SP - 607 EP - 11 JF - Liver international : official journal of the International Association for the Study of the Liver JO - Liver Int. VL - 27 IS - 5 N2 - BACKGROUND: The impact of superimposed non-alcoholic fatty liver disease (NAFLD) is well established in patients with chronic hepatitis C (CH-C), but the impact in patients with chronic hepatitis B (CH-B) is less clear. AIM: This study aims to evaluate the prevalence of NAFLD in patients with CH-B and the association with viral and host factors, particularly in patients with metabolic syndrome (MS). DESIGN: Data from patients with CH-B was obtained from our databases. Patients with excessive alcohol use were excluded. Hepatitis B virus (HBV) genotyping by INNO-LIPA was available for some patients. The presence of MS was defined according to the Adult Treatment Panel III (ATP III). All biopsies were read by two hepatopathologists using Metavir, modified histologic activity index (MHAI), as well as a NAFLD pathologic protocol. Patients were classified as (1) those without NAFLD; (2) those with simple hepatic steatosis; (3) and those with superimposed non-alcoholic steatohepatitis (NASH). Factors associated with superimposed NAFLD, its subtypes, and hepatic fibrosis were also analysed. RESULTS: Subjects included 153 HBV patients [66% male, age 50.5+/-27.5 years, body mass index 24.7+/-3.7 kg/m(2), waist 83.2+/-10.9 cm; 8.5% Caucasian, 67% Asian, aspartate aminotransferase (AST) 63.2+/-88.2 IU/l, alanine aminotransferase (ALT) 98.6+/-164.6 IU/l, glucose 111.6+/-50.5 mg/dl, HBV-DNA 1.8 x 10(8)+/-1.9 x 10(6) copies/ml, 7% with MS, 13% with diabetes, 20% with arterial hypertension and 8.5% with dyslipidaemia]. Liver biopsy was available for 64 subjects [19% had superimposed NAFLD, 13% had superimposed NASH, 86% had some degree of fibrosis, and 39% had advanced fibrosis (Ishak >3)]. Patients with HBV and superimposed NASH were significantly older (55 vs. 42 years, P=0.008), more likely to have hypertension (63% vs. 15%, P=0.006) and dyslipidaemia (50% vs. 8%, P=0.006), and had a larger waist circumference (92 vs. 83 cm, P=0.03). The presence of fibrosis was associated with higher waist circumference (84 vs. 80 cm, P=0.03), higher HBV-DNA (1.9 x 10(8) vs. 5 x 10(6) copies/ml, P=0.005), and elevated ALT >40 IU/l (73.6% vs. 33.3%, P=0.02). CONCLUSIONS: The components of MS (obesity, hypertension, and dyslipidaemia) are associated with the presence of NASH in patients with CH-B. The presence of hepatic fibrosis seems to be associated with known host and viral factors as well as the presence of abdominal obesity. SN - 1478-3223 UR - https://www.unboundmedicine.com/medline/citation/17498244/Impact_of_non_alcoholic_fatty_liver_disease_on_chronic_hepatitis_B_ L2 - https://doi.org/10.1111/j.1478-3231.2007.01482.x DB - PRIME DP - Unbound Medicine ER -