Published online Feb 27, 2023. doi: 10.4254/wjh.v15.i2.237
Peer-review started: November 22, 2022
First decision: December 10, 2022
Revised: December 14, 2022
Accepted: January 17, 2023
Article in press: January 17, 2023
Published online: February 27, 2023
Processing time: 93 Days and 15.6 Hours
Chronic hepatitis B (CHB) virus infection and nonalcoholic fatty liver disease (NAFLD) are important causes of liver-related complications and death. With the increasing prevalence of NAFLD, the number of patients with combined NAFLD and hepatitis B virus (HBV) infection is also on the increase.
This study aimed to further explore the impact of NAFLD and the pathological changes confirmed by liver pathology in patients with chronic HBV infection.
To study the effect of NAFLD confirmed using liver pathology on the outcomes of long-term serious adverse events in patients with CHB virus infection.
Among 456 cases of chronic HBV infection, 152 were confirmed by liver histology to have NAFLD, and 304 were simple chronic HBV infection. The incidence of serious clinical events at the follow-up endpoint was compared by Kaplan-Meier (K-M) survival analysis at baseline using propensity score matching balance parameters.
After a median follow-up of 70.5 mo, there were 34 cases of ultrasound-diagnosed cirrhosis and 10 cases of HCC. K-M survival analysis showed no significant difference in the occurrence of CHB complicated with NAFLD cirrhosis, and the cumulative incidence of HCC in the NAFLD group was higher than that in the non-NAFLD group (log-rank test, P < 0.05). Hepatocyte ballooning and severe liver fibrosis were also associated with an increased risk of HCC (log-rank test, all P < 0.05).
Baseline hepatocyte ballooning is a risk factor for adverse events in patients with CHB complicated with NAFLD.
Larger samples and more rigorous prospective studies are needed for further verification. The study cohort needs to be observed for a longer time, and the conclusion may change if this is done, in the study.