Editor's note:The 74th Annual Meeting of the American Association for the Study of Liver Diseases (AASLD 2023) was held in Boston, USA from November 10 to 14, 2023 local time.
HBV infection and nonalcoholic fatty liver disease (NAFLD) often coexist in patients. A meta-analysis published by Professor Cao Zhenhuan's team from Beijing You'an Hospital, Capital Medical University, in the abstract of the AASLD 2023 conference shows:Hepatic steatosis had no significant effect on efficacy in patients with chronic hepatitis B who received antiviral**, and both HBEAG and HBsAg clearance were higher in patients receiving PEG IFN** than in the NA** group.
Research Methods:PubM, Embase, Cochrane Library, and Web of Science were searched from inception to 22 July 2022. Data were collected and meta-analysed using fixed or random models.
Findings:Fourteen studies involving 2591 patients with chronic hepatitis B were included. At 48 and 96 weeks of nucleoside analogue (Na)**, patients with chronic hepatitis B with hepatic steatosis had a significantly lower rate of ALT normalization than those without hepatic steatosis (60% vs. 72%; 62% vs. 74%，p < 0.001), while there was no significant difference in ALT revertence rates in patients with chronic hepatitis B with or without hepatic steatosis who received pegylated interferon (PEG IFN)*. Patients with chronic hepatitis B with hepatic steatosis who received NA and PEG IFN**, respectively, had a significantly lower rate of HBV DNA inhibition at week 48 than patients without hepatic steatosis (64% vs. . 76%, p < 0.001; 39% vs. 45%; p = 0.043), while there was no significant difference in the NA** group at week 96.
The HBEAG clearance and HBSAG clearance in the PEG IFN** group were higher than those in the NA** group。Hbeag and HBsAg clearance at week 48 in patients with chronic hepatitis B with or without hepatic steatosis who received NA and PEG IFN**There were no significant differences
Relationship between hepatic steatosis and ALT normalization rate, HBV DNA inhibition rate, HBeAg and HBsAg clearance at 48 and 96 weeks
Conclusions of the studyHepatic steatosis had no significant effect on the efficacy of NA and PEG IFN **. Hepatic steatosis may have reduced HBV DNA inhibition for a short period of time in NA**, but this effect disappears with the extension of time. There are fewer studies on the antiviral effects of PEG IFN in patients with hepatic steatosis and chronic hepatitis B, and more research is needed, especially in the long term**.
Liver Linjun has something to saySeveral studies have explored the antiviral efficacy of patients with chronic hepatitis B and fatty liver disease, some studies have shown that patients with chronic hepatitis B and fatty liver have better antiviral efficacy, and some studies have shown that the antiviral efficacy of chronic hepatitis B patients with and without fatty liver is similar. In this study, it was also found that patients with chronic hepatitis B with and without fatty liver had similar efficacy when receiving nucleoside or pegylated interferon (PEG IFN), and that patients receiving PEG IFN** achieved higher HBsAg clearance. Interferon has the dual ability to inhibit viral replication and activate the immune response. At present, a large number of studies have confirmed that the PEG IFN-based ** strategy in patients with chronic hepatitis B can achieve a high clinical ** rate and better persistence. Due to the large base of patients with hepatitis B and fatty liver in China, early acceptance of a reasonable antiviral regimen is conducive to slowing down the progression of the disease and obtaining better outcomes.
References:
liu ll, li hong, zhou dq, et al. the impact of hepatic steatosis on response of antiviral therapy in chb patients: a meta-analysis [j]. aasld2023, abstracts (1395-c).
Hepatitis B