Impact of Nonalcoholic Fatty Liver Disease on Chronic Hepatitis B Virus Treatment

Strategic Insights -

Researchers from Xuzhou Medical College in Xuzhou, People's Republic of China, have conducted a retrospective study to determine the effects of nonalcoholic fatty liver disease (NAFLD) on chronic hepatitis B virus (HBV) treatment. The study involved 158 patients with chronic HBV who received pegylated interferon (PEG-IFN) therapy in addition to nucleos(t)ide analogues (NAs) treatment. The results showed that NAFLD did not significantly affect the achievement of functional cure in HBV patients, but those with NAFLD had a reduced likelihood of alanine aminotransferase (ALT) normalization during treatment.

Key Takeaways:

  • The study included 158 patients with chronic HBV, of which 91 had HBV-only and 67 had HBV with NAFLD.
  • After 48 weeks of PEG-IFN therapy, 20.9% of patients achieved HBsAg seroclearance, regardless of NAFLD status.
  • Logistic regression analysis indicated that baseline HBeAg status was independently associated with HBsAg seroclearance.
  • NAFLD did not significantly affect HBsAg loss, regardless of HBeAg status, before and after propensity score matching.
  • However, the NAFLD group exhibited higher rates of abnormal ALT at weeks 24 and 48 versus the HBV-only group.
  • ALT normalization rates 24 weeks post-treatment showed no significant difference between the two groups.

Statistics:

  • 20.9% of patients achieved HBsAg seroclearance after 48 weeks of PEG-IFN therapy.
  • 25.3% of patients in the HBV-only group achieved HBsAg seroclearance before propensity score matching.
  • 14.9% of patients in the HBV-NAFLD group achieved HBsAg seroclearance before propensity score matching.
  • 32.4% of patients in the HBV-only group achieved HBsAg seroclearance after propensity score matching.
  • 13.5% of patients in the HBV-NAFLD group achieved HBsAg seroclearance after propensity score matching.
  • 31.9% of patients in the NAFLD group had abnormal ALT at week 24.
  • 12.3% of patients in the HBV-only group had abnormal ALT at week 24.
  • 70.8% of patients in the NAFLD group had abnormal ALT at week 48.
  • 47.4% of patients in the HBV-only group had abnormal ALT at week 48.
  • 88.9% of patients in the NAFLD group had ALT normalization rates 24 weeks post-treatment.
  • 77.2% of patients in the HBV-only group had ALT normalization rates 24 weeks post-treatment.

Sources:

  • Huili Li, Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical College, Jiangsu, Xuzhou, People's Republic of China.
  • Ling Li, Yiru Zhao, Guangde Yang, Xia Wang, Juanjuan Fu, Li Li, Xiucheng Pan, Xuzhou Medical College, Xuzhou, People's Republic of China.
  • [Impact of nonalcoholic fatty liver disease on the functional cure of nucleos(t)ide analogues-treated chronic hepatitis B patients add-on pegylated interferon therapy: a retrospective study]. PeerJ, 2025, 13(0):e19972. doi: 10.7717/peerj.19972