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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

See all articles by Lu Wang

Lu Wang

Peking University - School of Basic Medical Sciences; Government of the People's Republic of China - Fifth Medical Centre

Yijin Wang

Government of the People's Republic of China - Department of Pathology and Hepatology

Shuhong Liu

Government of the People's Republic of China - Department of Pathology and Hepatology

Xiangwei Zhai

Peking University - School of Basic Medical Sciences

Guangde Zhou

Government of the People's Republic of China - Fifth Medical Centre

Fengmin Lu

Peking University - State Key Laboratory of Natural and Biomimetic Drugs

Jingmin Zhao

Government of the People's Republic of China - Department of Pathology and Hepatology

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

Suggested Citation

Wang, Lu and Wang, Yijin and Liu, Shuhong and Zhai, Xiangwei and Zhou, Guangde and Lu, Fengmin and Zhao, Jingmin, Nonalcoholic Fatty Liver Disease Is Associated with Lower Hepatitis B Viral Load and Antiviral Response in Pediatric Population (March 8, 2019). Available at SSRN: https://ssrn.com/abstract=3349214 or http://dx.doi.org/10.2139/ssrn.3349214

Lu Wang

Peking University - School of Basic Medical Sciences ( email )

38 Xueyuan Rd
Haidian District
Beijing, 100191
China

Government of the People's Republic of China - Fifth Medical Centre ( email )

Beijing
China

Yijin Wang

Government of the People's Republic of China - Department of Pathology and Hepatology ( email )

China

Shuhong Liu

Government of the People's Republic of China - Department of Pathology and Hepatology ( email )

China

Xiangwei Zhai

Peking University - School of Basic Medical Sciences ( email )

38 Xueyuan Rd
Haidian District
Beijing, 100191
China

Guangde Zhou

Government of the People's Republic of China - Fifth Medical Centre ( email )

Beijing
China

Fengmin Lu

Peking University - State Key Laboratory of Natural and Biomimetic Drugs ( email )

Beijing, 100191
China

Jingmin Zhao (Contact Author)

Government of the People's Republic of China - Department of Pathology and Hepatology ( email )

China

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