Hepatic Steatosis: Prevalence and Host/Viral Risk Factors in Iranian Patients with Chronic Hepatitis B Infection

Background: In chronic hepatitis B (CHB), the presence of hepatic steatosis (HS) seems to be associated withknown host and viral factors which may influence the long-term prognosis of chronic hepatitis B (CHB), probablyleading to cirrhosis and hepatocellular carcinoma (HCC). Different from chronic hepatitis C (CHC), factorsassociated with HS in CHB are not clearly explored. Materials and
Methods: 160 CHB patients were divided intotwo groups depending on the results of liver biopsy. Group I consisted of 71 patients with confirmed steatosis.Group II comprised 89 patients without steatosis. The groups were compared in terms of basal characteristics,body mass index (BMI), liver enzymes (ALT, AST, ALP), serum fasting blood sugar (FBS) and lipids, hepatitis Be antigen (HBeAg), viral load, and histological findings.
Results: In terms of host factors, male gender, older age,BMI, high serum FBS and lipid levels were associated with HS. On the other hand, ALT levels, the HAI scoresof necroinflammation and stage of fibrosis did not associate with HS. On multivariate analysis, parameters ofsex, BMI, cholesterol and FBS levels were independently associated with HS. Regarding viral factors, HBeAgnegativity was significantly associated with HS (81.7%, p value 0.006), but not HBV DNA level (p value 0.520).
Conclusions: HS in CHB appears to be unrelated to the status of HBV replication. However, fibrosis progressionin CHB is related to variable host factors. HS may be enhanced through these factors in HBV chronic patients.