4.7 Review

Impact of NAFLD on the outcome of patients with chronic hepatitis B in Asia

Journal

LIVER INTERNATIONAL
Volume 42, Issue 9, Pages 1981-1990

Publisher

WILEY
DOI: 10.1111/liv.15252

Keywords

all-cause mortality; hepatitis B surface antigen; hepatocellular carcinoma; liver cirrhosis; liver fibrosis; sustained virologic response

Funding

  1. National Natural Science Foundation of China [81870407]

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Hepatitis B virus (HBV) infection and nonalcoholic fatty liver disease (NAFLD) are two major causes of chronic liver disease (CLD) that can cause liver cirrhosis and hepatocellular carcinoma (HCC). It is becoming increasingly common in Asia to have concurrent NAFLD in chronic HBV infection. Although CHB patients tend to have a lower prevalence and incidence of NAFLD than the general population, concurrent NAFLD among CHB patients is still common and has an upward trend over time.
Hepatitis B virus (HBV) infection and nonalcoholic fatty liver disease (NAFLD) are two major causes of chronic liver disease (CLD) that can cause liver cirrhosis and hepatocellular carcinoma (HCC). It is a trend to superimpose NAFLD on chronic HBV infection in Asia. This review presents the epidemiology of concurrent NAFLD in chronic hepatitis B (CHB) patients and focuses on the impact of concurrent NAFLD on the outcome of CHB patients in Asia. Although CHB patients tend to have a lower prevalence and incidence of NAFLD than the general population, concurrent NAFLD among CHB patients is still common and has an upward trend over time. Concurrent NAFLD can promote hepatitis B surface antigen (HBsAg) seroclearance and might inhibit HBV replication but exacerbate liver fibrosis. The impacts of concurrent NAFLD on HCC risk, all-cause mortality and antiviral treatment response in CHB patients remain controversial.

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