Lu Wang1,2, Yijin Wang3, Shuhong Liu2, Xiangwei Zhai1, Guangde Zhou2, Fengmin Lu4, Jingmin Zhao5. 1. State Key Laboratory of Natural and Biomimetic Drugs, Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, 100191, P. R. China. 2. Department of Pathology and Hepatology, The 5th Medical Centre, Chinese PLA General Hospital, Xisihuan Middle Road NO.100, Beijing, 100039, P. R. China. 3. Department of Pathology and Hepatology, The 5th Medical Centre, Chinese PLA General Hospital, Xisihuan Middle Road NO.100, Beijing, 100039, P. R. China. yijinwang927015@163.com. 4. State Key Laboratory of Natural and Biomimetic Drugs, Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, 100191, P. R. China. lu.fengmin@hsc.pku.edu.cn. 5. Department of Pathology and Hepatology, The 5th Medical Centre, Chinese PLA General Hospital, Xisihuan Middle Road NO.100, Beijing, 100039, P. R. China. jmzhao302@163.com.
Abstract
BACKGROUND: The interaction between nonalcoholic fatty liver disease (NAFLD) and chronic hepatitis B infection (CBI) was unclear. We aimed to investigate the association between NAFLD and CBI and the effect of NAFLD on response to antiviral therapy in pediatric population. METHODS: All children aged 0-18 years with liver biopsy-proven NAFLD, CBI, and co-existing NAFLD and CBI were consecutively collected. Children with co-existing CBI and NAFLD were considered as cases and n:m matched with simple NAFLD and simple CBI patients in the same cohort, respectively. In longitude study, the role of NAFLD in antiviral response was further analyzed in children with CBI who received antiviral treatment. Logistic or Cox regression models were used appropriately for analysis. RESULTS: 765 subjects were finally enrolled with 62 co-existing patients, 560 CBI patients, and 143 NAFLD patients. Multivariate analysis showed that HBV DNA level was negatively associated with NAFLD in CBI children (OR 0.376, 95% CI 0.173-0.818). Conversely, the severity of steatosis and levels of serum lipid profile were found to be inversely associated with CBI in NAFLD subjects. Then, in longitude study, we found that HBsAg loss at 96 weeks of antiviral treatment was independently associated with NAFLD (aHR 3.245, 95% CI 1.288-8.176). CONCLUSIONS: An inverse association between CBI and NAFLD reciprocally existed in pediatric population. In longitude study, HBsAg loss was associated with NAFLD at week 96 of antiviral therapy.
BACKGROUND: The interaction between nonalcoholic fatty liver disease (NAFLD) and chronic hepatitis B infection (CBI) was unclear. We aimed to investigate the association between NAFLD and CBI and the effect of NAFLD on response to antiviral therapy in pediatric population. METHODS: All children aged 0-18 years with liver biopsy-proven NAFLD, CBI, and co-existing NAFLD and CBI were consecutively collected. Children with co-existing CBI and NAFLD were considered as cases and n:m matched with simple NAFLD and simple CBI patients in the same cohort, respectively. In longitude study, the role of NAFLD in antiviral response was further analyzed in children with CBI who received antiviral treatment. Logistic or Cox regression models were used appropriately for analysis. RESULTS: 765 subjects were finally enrolled with 62 co-existing patients, 560 CBI patients, and 143 NAFLD patients. Multivariate analysis showed that HBV DNA level was negatively associated with NAFLD in CBI children (OR 0.376, 95% CI 0.173-0.818). Conversely, the severity of steatosis and levels of serum lipid profile were found to be inversely associated with CBI in NAFLD subjects. Then, in longitude study, we found that HBsAg loss at 96 weeks of antiviral treatment was independently associated with NAFLD (aHR 3.245, 95% CI 1.288-8.176). CONCLUSIONS: An inverse association between CBI and NAFLD reciprocally existed in pediatric population. In longitude study, HBsAg loss was associated with NAFLD at week 96 of antiviral therapy.
Entities:
Keywords:
Antiviral treatment; Chronic hepatitis B infection (CBI); Lipid metabolism; Nonalcoholic fatty liver disease (NAFLD); Pediatric population
Authors: Wai-Kay Seto; Rex W H Hui; Lung-Yi Mak; James Fung; Ka-Shing Cheung; Kevin S H Liu; Danny Ka-Ho Wong; Ching-Lung Lai; Man-Fung Yuen Journal: Clin Gastroenterol Hepatol Date: 2017-09-29 Impact factor: 11.382