Shi YW, Yang RX, Fan JG. Chronic hepatitis B infection with concomitant hepatic steatosis: Current evidence and opinion. World J Gastroenterol 2021; 27(26): 3971-3983 [PMID: 34326608 DOI: 10.3748/wjg.v27.i26.3971]
Corresponding Author of This Article
Jian-Gao Fan, MD, PhD, Chief Physician, Professor, Center for Fatty Liver, Department of Gastroenterology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Key Lab of Pediatric Gastroenterology and Nutrition, No. 1665 Kongjiang Road, Shanghai 200092, China. fanjiangao@xinhuamed.com.cn
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Opinion Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Jul 14, 2021; 27(26): 3971-3983 Published online Jul 14, 2021. doi: 10.3748/wjg.v27.i26.3971
Chronic hepatitis B infection with concomitant hepatic steatosis: Current evidence and opinion
Yi-Wen Shi, Rui-Xu Yang, Jian-Gao Fan
Yi-Wen Shi, Rui-Xu Yang, Jian-Gao Fan, Center for Fatty Liver, Department of Gastroenterology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Key Lab of Pediatric Gastroenterology and Nutrition, Shanghai 200092, China
Author contributions: Shi YW, Yang RX and Fan JG contributed to the study concept and design; Shi YW and Fan JG contributed to drafting the manuscript; Fan JG contributed to critical revision of the manuscript for important intellectual content; All authors confirmed critical revision of the manuscript for important intellectual content.
Supported byNational Key Research and Development Program of China, No. 2017YFC0908903; and National Natural Science Foundation of China, No. 81873565 and No. 81900507.
Conflict-of-interest statement: The authors declare that theyhaveno competinginterests.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian-Gao Fan, MD, PhD, Chief Physician, Professor, Center for Fatty Liver, Department of Gastroenterology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Key Lab of Pediatric Gastroenterology and Nutrition, No. 1665 Kongjiang Road, Shanghai 200092, China. fanjiangao@xinhuamed.com.cn
Received: February 6, 2021 Peer-review started: February 6, 2021 First decision: April 19, 2021 Revised: April 28, 2021 Accepted: May 27, 2021 Article in press: May 27, 2021 Published online: July 14, 2021
Abstract
With the increasing incidence of obesity and metabolic syndrome worldwide, concomitant nonalcoholic fatty liver disease (NAFLD) in patients with chronic hepatitis B (CHB) has become highly prevalent. The risk of dual etiologies, outcome, and mechanism of CHB with concomitant NAFLD have not been fully characterized. In this review, we assessed the overlapping prevalence of metabolic disorders and CHB, assessed the risk of advanced fibrosis/hepatocellular carcinoma in CHB patients concomitant with NAFLD, and discussed the remaining clinical issues to be addressed in the outcome of such patients. We also explored the possible roles of hepatitis B virus in the development of steatosis and discussed difficultiesof histological evaluation. For CHB patients, it is important to address concomitant NAFLD through lifestyle management and disease screening to achieve better prognoses. The assessment of progressive changes and novel therapies for CHB patients concomitant with NAFLD deserve further research.
Core Tip: The pathophysiology of concomitant hepatitis B and hepatic steatosis remains unclear. This review comprehensively discusses the epidemiology, risk factors, long-term outcomes, histological assessment, potential mechanisms, and therapeutic options in this field. We believe further studies can clarify the interactions of hepatitis B virus and steatosis, and provide novel strategies for the management of hepatitis B patients with concomitant steatosis.
