Prognostic impact of concurrent nonalcoholic fatty liver disease in patients with chronic hepatitis B‐related hepatocellular carcinoma

2020 ◽  
Vol 35 (11) ◽  
pp. 1960-1968 ◽  
Author(s):  
Jun Sik Yoon ◽  
Hyo Young Lee ◽  
Sung Won Chung ◽  
Sun Woong Kim ◽  
Young Chang ◽  
...  
Cancers ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 2301
Author(s):  
Minah Kim ◽  
Yeonju Lee ◽  
Jun Sik Yoon ◽  
Minjong Lee ◽  
So Shin Kye ◽  
...  

Background: The FIB-4 index, a noninvasive tool (FIB-4 index = age × aspartate transaminase (AST)/(platelet count × √alanine aminotransferase (ALT)), is a useful assessment for liver fibrosis. Patients with a high FIB-4 index were reported to have a high risk of developing hepatocellular carcinoma (HCC). This study analyzed the clinical association of the FIB-4 index with HCC development in patients with coexisting nonalcoholic fatty liver disease and chronic hepatitis B (NAFLD–CHB). Methods: This retrospective study analyzed 237 consecutive patients with NAFLD–CHB between January 2006 and December 2010 at the National Police Hospital in Korea. Patients with HCC at baseline and those diagnosed with HCC within 6 months from baseline were excluded. Propensity score matching analysis (PSM) was adopted to balance the baseline characteristics between patients with low and high FIB-4 index values. The cumulative rates of HCC development were compared between the two groups using the Kaplan–Meier method in the matched population. Results: The median follow-up duration was 13 years (interquartile range, 8.2–15.7). The optimal cutoff for the FIB-4 index of 1.77 was calculated based on the maximum Youden index value, with an AUC of 0.70. Among a total of 237 patients with NAFLD–CHB, HCC developed in 20 patients (8.4%) (14 of the 90 patients with a high FIB-4 index vs. 6 of the 147 patients (4.1%) with a low FIB-4 index; log-rank p = 0.003). Patients with a high FIB-4 index had a significantly and independently higher risk of HCC than those with a low FIB-4 index (adjusted hazard ratio, 4.35; 95%; confidence interval, 1.42–13.24; log-rank test, p = 0.006). Conclusion: A high FIB-4 index (≥1.77) might be a useful marker for predicting the development of HCC in patients with NAFLD–CHB.


2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
A. C. M. Nascimento ◽  
D. R. Maia ◽  
S. M. Neto ◽  
E. M. Lima ◽  
M. Twycross ◽  
...  

Nonalcoholic fatty liver disease (NAFLD) includes a wide spectrum of histological conditions, extending from simple steatosis to end-stage liver failure. The aim of this study was to examine the prevalence of NAFLD and its associations in chronic hepatitis B and C patients.Methods. We included all patients diagnosed with chronic hepatitis B and C who underwent a liver biopsy between January 2010 and October 2011 (n= 104). Parameters studied included hepatitis type, anthropometric data, histologic, hepatic, metabolic and lipid assessments, presence of hypertension and viral load.Results. Hepatitis B was presented in 28.8% (n= 30) of patients, while hepatitis C was presented in 71.2% (n= 74). In addition, hepatic steatosis was present in 25% (n= 26) of the patients. Steatosis was frequently found in hepatitis C patients (31.1%; 25%n= 23), but infrequently in hepatitis B patients (10%;n= 3) (P= 0.024). It was also found that steatosis was frequently present in hepatitis C patients with intense fibrosis (52.94%) (P= 0.025).Discussion. Our results suggest that steatosis is a common feature in patients with viral chronic hepatitis, and that it plays a different role in each type of hepatitis.


Author(s):  
Hira Hanif ◽  
Muzammil Khan ◽  
Mukarram Ali ◽  
Pir Shah ◽  
Jinendra Satiya ◽  
...  

Hepatitis B virus (HBV) infection remains a global public problem despite the availability of effective vaccine. In the past decades, nonalcoholic fatty liver disease (NAFLD) has surpassed HBV as the most common cause of chronic liver disease worldwide. The prevalence of concomitant chronic hepatitis B (CHB) and NAFLD, thus, reaches endemic in geographic regions where both conditions are common. Patients with CHB and NAFLD are at increased risk of liver disease progression to cirrhosis and hepatocellular carcinoma. Due to complexity of the pathogenesis, accurate diagnosis of NAFLD in CHB patients can be challenging. Liver biopsy is considered the gold standard for diagnosing and determining the disease severity, but it is an invasive procedure with potential complications. There is a growing body of literatures on the application of novel noninvasive serum biomarkers and advanced radiological modalities to diagnose and evaluate NAFLD, but most have not been adequately validated especially for patients with CHB. Currently, there is no approved therapy for NAFLD though many new agents are in different phases of development. This review provides a summary of the epidemiology, clinical features, diagnosis and management of the NAFLD and highlights the unmet needs in the areas of CHB and NAFLD coexistence.


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