Wang SW, Chang YW, Wang C, Cheng YM, Hsieh TH, Wang CC, Kao JH. Clinical profiles and their interaction of concurrent metabolic associated steatotic liver disease and hepatitis B virus infection. World J Hepatol 2024; 16(12): 1429-1440 [DOI: 10.4254/wjh.v16.i12.1429]
Corresponding Author of This Article
Chia-Chi Wang, PhD, Chief, Department of Hepatology, Taipei Tzu Chi Hospital, No. 289 Jianguo Road, Xindian Area, New Taipei City 23142, Taiwan. wangchiachi888@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
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/
Shao-Wen Wang, Department of Education, Taipei Medical University-Shuang Ho Hospital, Taipei 235, Taiwan
Yu-Wen Chang, Department of Gastroenterology and Hepatology, Taipei Tzu Chi Hospital, Taipei 231, Taiwan
Ching Wang, Department of Education, National Yang Ming Chiao Tung University, Hsinchu 300, Taiwan
Yu-Ming Cheng, Department of Gastroenterology and Hepatology, Tung’s Taichung MetroHarbor Hospital, Taichung 43503, Taiwan
Tsung-Han Hsieh, Research, Taipei Tzu Chi Hospital, Taipei 231, Taiwan
Chia-Chi Wang, Department of Hepatology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 23142, Taiwan
Jia-Horng Kao, Department of Internal Medicine, National Taiwan University College of Medicine, Taipei 100, Taiwan
Co-first authors: Shao-Wen Wang and Yu-Wen Chang.
Author contributions: Wang SW and Wang C contributed to writing of the article; Cheng YM and Hsieh TH contributed to statistical analysis; Wang CC contributed to concept, design and writing of the article; Kao JH contributed to revising the article. Wang SW and Chang YW contributed the same contribution and as such merited the designation of co-first authorship.
Supported byTaipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. TCRD-TPE-112-11.
Institutional review board statement: The authors declare the data were made available to and approved by the Ethics and Governance Council of the Taiwan Bio-bank (Approval Numbers: TWBR11102-03).
Informed consent statement: This was a retrospective study from the Taiwan Bio-bank. Therefore, this study did not require any informed consent forms.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Data sharing statement: The data that support the findings of this study are available from the corresponding author upon reasonable request.
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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chia-Chi Wang, PhD, Chief, Department of Hepatology, Taipei Tzu Chi Hospital, No. 289 Jianguo Road, Xindian Area, New Taipei City 23142, Taiwan. wangchiachi888@gmail.com
Received: May 23, 2024 Revised: July 23, 2024 Accepted: July 30, 2024 Published online: December 27, 2024 Processing time: 189 Days and 23.3 Hours
Abstract
BACKGROUND
A new nomenclature of metabolic associated steatotic liver disease (MASLD) was proposed in 2023, thus expanding the diagnostic name of “MASLD combined with other etiologies”.
AIM
To investigate the clinical profiles of patients with concurrent MASLD and chronic hepatitis B virus (HBV) infection.
METHODS
This study included participants from the Taiwan Bio-bank. The diagnostic criteria of MASLD encompassed hepatic steatosis and any cardio-metabolic risk factors. Positive hepatitis B surface antigen was considered indicative of chronic HBV infection. Dual etiology was defined as MASLD combined with chronic HBV infection (MASLD-HBV). Fibrosis 4 (FIB-4) score determined the severity of liver fibrosis, and atherosclerosis was diagnosed by the presence of carotid plaques on duplex ultrasound.
RESULTS
In a total of 18980 participants (mean age, 55.18 ± 10.35 years; males, 30.42%), there were 7654 (40.3%) MASLD patients and 2128 (11.2%) HBV carriers. After propensity score matching for age and gender, HBV carriers had a lower percentage of MASLD than healthy controls. Those with dual etiology had higher aspartate aminotransferase, alanine aminotransferase (ALT), and FIB-4 levels, but lower gamma glutamyl transferase (GGT) levels than MASLD patients. In contrast, those with dual etiology had higher ALT and GGT levels, but lower FIB-4 than “HBV alone” patients. The risk of atherosclerosis was similar among these three groups.
CONCLUSION
MASLD-HBV patients have worse liver fibrosis severity than MASLD patients, but better liver fibrosis stage than “HBV alone” patients, suggesting a complex interaction between MASLD and chronic HBV infection.
Core Tip: Patients with concurrent metabolic associated steatotic liver disease (MASLD) and hepatitis B virus (HBV) infection (MASLD-HBV) are occasionally encountered in clinical practice. They have different clinical profiles compared to MASLD or “HBV alone” patients. The patients with dual etiology have worse liver fibrosis severity than MASLD patients, but better liver fibrosis stage than “HBV alone” patients, suggesting a complex interaction between MASLD and chronic HBV infection.
