Abstract

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 center. 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=0.02), hypertensive (33.2% vs. 22.8%, P=0.009), male (67.4% vs. 57.3%, P=0.02) with a higher mean BMI (25.4±4.3 vs. 23.8±4.0 kg/m2 , P<0.001). Both cohorts achieved similar rates of CVS (86% vs. 88%) and BR (38% vs. 41%) during follow-up of up to 60 months (P>0.05), but NAFLD had higher cumulative rates of CVS+BR, compared with non-NAFLD patients (32.5% vs. 22.8%, P=0.03). In multivariate analyses, NAFLD was not independently associated with CVS and/or BR outcomes. Receipt of entecavir or tenofovir (versus 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.

View details for DOI 10.1111/liv.14415

View details for PubMedID 32086988