Prevalence of hepatic steatosis in chronic hepatitis B patients and its association with disease severity

Abstract

Aim: to know the prevalence of liver steatosis in chronic hepatitis B (CHB) patients and evaluate whether its presence was associated with a more progressive disease.

Methods: a cross-sectional study was conducted in Cipto Mangunkusumo and Medistra Hospitals, Jakarta on CHB patients between 2007 and 2009. Data on patients' demography, anthropometry, liver function test and hepatitis B serology were collected. Hepatic steatosis was assessed by liver biopsy and graded as mild (<33%), moderate (33-66%) or severe (>66%). Fibrosis stage and necroinflammatory activity were assessed according to the METAVIR system.

Results: one-hundred and seventy four patients were enrolled; 99 (56.9%) among them were men. Patients' mean age was 39.9 ± 10.69 years. About 56% of cases were HBeAg negative. The prevalence of liver steatosis was 29.9%. Patients with liver steatosis had significantly higher body mass index (25.1 ± 3.3 vs. 22.7 ± 3.33 kg/m2, p<0.001) and waist circumference (88.3 vs. 79.0 cm; p<0.001). No association between liver steatosis and HBeAg status (p=0.736). There were no differences of log HBV-DNA levels (5.72 ± 1.993 vs. 6.07 ± 2.077; p=0.675) and liver stiffness (8.3 ± 6.28 vs. 9.5 ± 10.18 kPa) between patients with and without liver steatosis. The presence of significant fibrosis (61.5% vs. 69.7%; p=0.295) and necroinflammation (63.5% vs. 65.6%; p=0.789) was not differed between patients with and without liver steatosis.

Conclusion: liver steatosis was found in 30% of chronic hepatitis B patients. Its presence was mostly associated with central obesity. Unlike chronic hepatitis C, liver steatosis in chronic hepatitis B was not related to a more progressive disease.