Editor’s Note:

From November 10th to 14th, 2023, the annual highlight in the field of hepatology—the American Association for the Study of Liver Diseases (AASLD) Annual Meeting 2023 was grandly held in Boston, USA. Dr. Zhenhuan Cao from Beijing You’an Hospital, Capital Medical University, as the corresponding author, presented a research abstract at the conference, revealing the influence of hepatic steatosis on the efficacy of antiviral therapy in patients with chronic hepatitis B (CHB). The results suggest that hepatic steatosis has no significant impact on the effectiveness of nucleos(t)ide analogs (NAs) and pegylated interferon (PEG-IFN) treatment [1]. Hepatology Digest reports on this, and the relevant content is shared below.

Research Background:

Hepatitis B virus (HBV) infection combined with non-alcoholic fatty liver disease (NAFLD) is very common. However, it is currently unclear whether hepatic steatosis affects the antiviral efficacy in patients with chronic hepatitis B (CHB).

Research Methods:

Literature searches were conducted on PubMed, EMBASE, Cochrane Library, and Web of Science from their inception until July 22, 2022. Data were collected and meta-analysis was performed using fixed or random models.

Research Results:

A total of 14 studies involving 2591 patients with chronic hepatitis B were included. At 48 and 96 weeks, the alanine aminotransferase (ALT) normalization rate in patients with CHB treated with nucleos(t)ide analogs (NAs) and concomitant hepatic steatosis was lower (60% vs. 72% and 62% vs. 74%, P<0.001), but there was no statistically significant difference in pegylated interferon (PEG-IFN) treatment.

At 48 weeks, patients with hepatic steatosis had a lower HBV DNA suppression rate in both NA and PEG-IFN treatment groups (64% vs. 76%, P<0.001 and 39% vs. 45%, P=0.043), while there was no statistically significant difference in the NA treatment group at 96 weeks. The PEG-IFN group had higher rates of hepatitis B e antigen (HBeAg) and hepatitis B surface antigen (HBsAg) clearance than the NA group. At 48 weeks, there was no significant difference in HBeAg and HBsAg clearance rates between CHB patients with or without hepatic steatosis treated with NA or PEG-IFN.

Research Conclusion:

Hepatic steatosis has no significant impact on the efficacy of NA and PEG-IFN treatments. Hepatic steatosis may temporarily reduce the inhibition of HBV DNA by NA treatment, but this effect disappears with prolonged treatment. There is limited research on the impact of hepatic steatosis on the antiviral effects of PEG-IFN, and more research is needed, especially in the context of long-term treatment.

Reference:

[1] Liu L, Li H, Zhou D, et al. The Impact of hepatic steatosis on the response of antiviral therapy in CHB patients: a meta-analysis. AASLD 2023. Poster 1395-C.