Background and Aims: Hepatic steatosis is commonly seen in chronic hepatitis C (CHC) patients. It has been reported to be associated with both metabolic factors and viral factors, and affects the severity of fibrosis in CHC. However, the relationship between hepatic steatosis and chronic hepatitis B (CHB) is unclear. The aims of this study were to investigate the frequency of hepatic steatosis in CHB patients, to identify the factors associated with its presence, and assess the relationship between the stage of steatosis and the severity of fibrosis.
Methods: Medical records of 153 adult patients with CHB who had undergone a liver biopsy within the past 4 years were included in the study.
Results: Body mass index (BMI) and age of CHB patients with steatosis was significantly higher than the patients without steatosis (P < 0.05), as determined by the univariate analysis. Steatosis was found to correlate with the BMI values and alanine aminotransferase (ALT) levels, and ALT levels were associated with hepatitis B virus (HBV)-DNA levels and histology activity index (HAI) scores, stages of fibrosis were associated with the HAI score and HBV-DNA, as determined by the multivariate analysis. In contrast, there was no significant association between advanced stages of fibrosis and steatosis.
Conclusion: Our data indicate that hepatic steatosis is more frequently present in CHB patients than in the general population. We hypothesize that steatosis in CHB patients may be due to metabolic factors and the ability of HBV to indirectly facilitate the development of steatosis. In the present study, steatosis in CHB patients was not found to be associated with the severity of fibrosis.
Non-alcoholic fatty liver disease (NAFLD) is one of the most common liver diseases, affecting 10-24% of the general population in various countries. The prevalence of NAFLD has increased in the past couple years in relation to the increasing number of obese, type 2 diabetic individuals. NAFLD now refers to a wide spectrum of liver damage, ranging from simple steatosis to steatohepatitis, advanced fibrosis, and even cirrhosis. Hepatic steatosis is the primary histological feature of NAFLD, which has been reported to be a common histological feature of chronic hepatitis C (CHC), and was associated with both metabolic factors and viral factors, and affects the severity of fibrosis in CHC. Hepatitis B virus (HBV) is estimated to have infected more than two billion people worldwide, of whom more than 350 million have chronic infections. Chronically-infected people have a higher risk of death from cirrhosis and liver cancer, which kill approximately one million people each year. Up to now, only a few studies have addressed the prevalence of steatosis in biopsy-proven chronic hepatitis B (CHB) patients, in which steatosis has been shown to be associated only with metabolic factors, but not with the fibrosis. However, to our knowledge, no study has evaluated CHB steatosis in a Chinese population. Therefore, we conducted a retrospective study of patients with CHB, and based on the data collected for each patient, we analyzed factors that may be associated with steatosis in order to determine the relationship between steatosis and body mass index (BMI), HBV-DNA, and liver lesions, including severity of necroinflammation and stage of fibrosis.