The interaction between chronic hepatitis B and hepatic steatosis is poorly understood.
Dr Wai-Kay Seto and colleagues from Hong Kong investigated whether measurement of controlled attenuation parameter, a non-invasive method to quantify steatosis, can assist in monitoring patients with chronic hepatitis B.
The team of doctors performed transient elastography, to measure liver stiffness, and made controlled attenuation parameter measurements in 1606 patients with chronic hepatitis B in Hong Kong, from 2015 through 2016.
The doctor's also collected information on patients’ medical history, current treatment, and smoking and alcohol habits, anthropometric measurements.
The reseachers obtained and analyzed fasting blood samples.
Severe liver fibrosis was defined, according to guidelines, as a liver stiffness measurement greater than 9.0 kPa in patients with normal level of alanine aminotransferase or greater than 12.0 kPa in patients with a level of lanine aminotransferase 1–5-fold the upper limit of normal.
Steatosis was defined as a controlled attenuation parameter measurement of 248 dB/m or more, and severe steatosis as a controlled attenuation parameter measurement or 280 dB/m more.
|With every increase in controlled attenuation parameter value of 10
dB/m, the risk of severe fibrosis increased by 15% in treatment-naïve
|Clinical Gastroenterology and Hepatology
The team performed multivariate analysis to identify factors associated with severe fibrosis.
The prevalence of steatosis, severe steatosis, and severe fibrosis in our cohort were 41%, 23%, and 14%, respectively.
A higher proportion of patients with severe steatosis had severe fibrosis.
The researchers found that severe steatosis was associated with severe fibrosis in treatment-naïve patients and in patients receiving treatment.
With every increase in controlled attenuation parameter value of 10 dB/m, the risk of severe fibrosis increased by 15% in treatment-naïve patients and by 7%–8% in patients receiving treatment.
Dr Seto's team concluded, "Severe steatosis, determined by controlled attenuation parameter measurement, is associated with severe fibrosis in treatment-naïve patients with chronic hepatitis B and in patients receiving treatment."
"Longitudinal studies are required to investigate if steatosis control, in addition to antiviral treatment, can reduce the burden fibrosis in patients with chronic hepatitis B."