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Nonalcoholic Fatty Liver Disease Is Associated with Lower Hepatitis B Viral Load and Antiviral Response in Pediatric Population
20 Pages Posted: 11 Mar 2019
More...Abstract
Both nonalcoholic fatty liver disease (NAFLD) and chronic hepatitis B infection (CBI) are the most prevalent liver diseases and 25-30% of CBI patients are estimated to have co-existing NAFLD, the interaction between hepatic steatosis and HBV infection and their contribution to liver disease course is an emerging interest. This study explored the association between CBI and NAFLD and the effect of NAFLD on response to antiviral therapy in pediatric population. All children aged 0-18 years with liver biopsy-proven NAFLD, CBI or co-existing NAFLD and CBI were consecutively collected from January 2010 to March 2018 in a tertiary hospital in China. Patients with co-existing CBI and NAFLD were considered as cases and n:m matched with simple NAFLD and simple CBI patients in the same cohort, respectively. 765 subjects were finally enrolled with 62 co-existing patients, 560 CBI patients and 143 NAFLD patients. Multivariate analysis showed that HBV DNA level was negatively associated with NAFLD in CBI children (OR 0.376, 95%CI 0.173-0.818). Conversely, the severity of steatosis and levels of serum lipid profile were found to be inversely associated with CBI in NAFLD subjects. In longitude study, we found HBsAg loss at 96 weeks of antiviral treatment was independently associated with NAFLD (aHR 3.245, 95%CI 1.288-8.176). The data demonstrated that an inverse association between CBI and NAFLD mutually existed in pediatric population. In longitude study, HBsAg loss was associated with NAFLD at week 96 of antiviral therapy.
Funding: This work was supported by National Natural Science Foundation of China (81673654 to J.Z.); National Science and Technology Major Project of the Ministry of Science and Technology of China (2017ZX10202203, 2017ZX10302201, 2017ZX10202202 to F.L.); National Natural Science Foundation of China (31770186 and 81802020 to Y. W.); Research Found of Capital Medical Development (2014-2-5032 to J.Z.)
Declaration of Interest: There are no conflicts of interest.
Ethical Approval: This investigation was performed according to the guidelines of the Declaration of Helsinki. This study has been approved by the local Ethics Committee.
Keywords: Nonalcoholic fatty liver disease (NAFLD); Chronic hepatitis B infection (CBI); Lipid metabolism; Antiviral treatment; Pediatric population
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