Chronic hepatitis B associated with hepatic steatosis, insulin resistance, necroinflammation and fibrosis

Afr Health Sci. 2015 Sep;15(3):714-8. doi: 10.4314/ahs.v15i3.3.

Abstract

Background: The effect of hepatitis B virus (HBV) infection on fatty liver disease is unclear.

Objectives: The aim of this study was to investigate the viral and host causes of fatty liver in chronic hepatitis B (CHB) patients. This study included 88 CHB patients of which 17 were not treated. Liver biopsy was performed in each patient. Group 1 included those with hepatic steatosis (n=28) and group 2 those without hepatic steatosis. The groups were compared in terms of age, body mass index (BMI), Homeostasis Model Assessment- Insulin Resistance (HOMA-IR), viral load, biochemical parameters and histological findings. Patients in group 1 were subdivided according to the degree of steatosis as follows: grade 1 (15 patients, 53.6%), grade 2 (6 patients, 21.4%), and grade 3 (7 patients, 25%).

Results: In group 1 (n=28), mean age, BMI, cholesterol, and HOMA-IR were found to be significantly higher than in group 2 (n=60). There were no significant differences in the positivity of viral load, HbeAg, treatment, fibrosis and other laboratory parameters between the two groups. HOMA-IR was the only independent predictive factor of liver steatosis in patients with CHB in logistic regression analysis.

Conclusion: Hepatic steatosis in CHB patients was associated with host metabolic factors.

Keywords: BMI; Chronic hepatitis B; HOMA-IR; biopsy; liver steatosis.

MeSH terms

  • Adult
  • Alanine Transaminase
  • Biopsy
  • Cholesterol / blood
  • Fatty Liver / complications
  • Fatty Liver / epidemiology*
  • Fatty Liver / etiology
  • Fatty Liver / pathology
  • Female
  • Hepatitis B virus / immunology
  • Hepatitis B, Chronic / epidemiology*
  • Hepatitis B, Chronic / metabolism
  • Hepatitis C, Chronic / epidemiology*
  • Hepatitis C, Chronic / metabolism
  • Humans
  • Insulin / blood
  • Insulin Resistance* / physiology
  • Liver / pathology
  • Liver Cirrhosis / diagnosis*
  • Liver Cirrhosis / etiology
  • Liver Cirrhosis / pathology
  • Male
  • Middle Aged
  • Non-alcoholic Fatty Liver Disease / epidemiology*
  • Non-alcoholic Fatty Liver Disease / metabolism
  • Non-alcoholic Fatty Liver Disease / virology
  • Prevalence
  • Severity of Illness Index
  • Viral Load

Substances

  • Insulin
  • Cholesterol
  • Alanine Transaminase