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. 2021 Dec;9(23):1718.
doi: 10.21037/atm-21-3052.

Concurrence and impact of hepatic steatosis on chronic hepatitis B patients: a systematic review and meta-analysis

Daixi Jiang #  1 , Can Chen #  1 , Xiaoxiao Liu  1 , Chenyang Huang  1 , Danying Yan  1 , Xiaobao Zhang  1 , Yuqing Zhou  1 , Yushi Lin  1 , Yiyi Zhou  1 , Zhou Guan  1 , Cheng Ding  1 , Lei Lan  1 , Changtai Zhu  2 , Jie Wu  1 , Lanjuan Li  1 , Shigui Yang  1
Affiliations

Concurrence and impact of hepatic steatosis on chronic hepatitis B patients: a systematic review and meta-analysis

Daixi Jiang et al. Ann Transl Med. 2021 Dec.

Abstract

Background: The association between hepatic steatosis (HS) and chronic hepatitis B (CHB) remains controversial. We performed a systematic review and meta-analysis to investigate the latest concurrence rate and impact of HS on CHB patients.

Methods: Relevant studies were identified by searching PubMed, EMBASE, and the Cochrane Library from January 1, 2000 to December 2, 2020. We calculated the pooled prevalence of HS in CHB patients using a random effects model. A subgroup analysis was performed to explore the impact of HS on CHB patients. This study is registered with PROSPERO (No. CRD42021242584).

Results: A total of 98 studies with a population of 48,472 patients were included. The global prevalence of HS in CHB patients was 34.93% [95% confidence interval (CI): 32.01-37.90%]. Overweight status, hypertension, diabetes, hyperlipidemia, and metabolic syndrome showed a higher risk for developing HS in CHB patients, while positive hepatitis B e antigen (HBeAg) status was negatively associated with the presence of HS [odds ratio (OR) =0.81, 95% CI: 0.70-0.93]. The pooled analysis showed no significant association between HS and fibrosis progression (OR =0.68, 95% CI: 0.44-1.05). However, the coexistence of HS was negatively associated with the antiviral therapy response in CHB patients, including virological response (OR =0.69, 95% CI: 0.48-0.99) and alanine aminotransferase (ALT) normalization (OR =0.44, 95% CI: 0.28-0.69).

Discussion: The global prevalence of HS in CHB patients is higher than previously estimated. The concurrence of HS could impact the replication of HBV and the effectiveness of antiviral therapy in CHB patients. However, coexistence with HS did not show a higher risk of developing advanced fibrosis in CHB patients.

Keywords: Hepatic steatosis (HS); chronic hepatitis B (CHB); concurrence; influence factors; meta-analysis.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://dx.doi.org/10.21037/atm-21-3052). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
The study selection process for this meta-analysis.
Figure 2
Figure 2
The pooled overall nationwide prevalence of HS in CHB patients. HS, hepatic steatosis; CHB, chronic hepatitis B.
Figure 3
Figure 3
The forest plots of the meta-analysis on demographic and diagnostic features. CI, confidence interval; WHO, World Health Organization; CAP, controlled attenuation parameter; MRS, magnetic resonance spectroscopy.
Figure 4
Figure 4
The forest plots of the meta-analysis on the impact of HS on fibrosis progression and the effectiveness of antiviral therapy in CHB patients. CI, confidence interval; ALT, alanine transaminase; OR, odds ratio.
See this image and copyright information in PMC

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