Liu SY, Wang D, Liu J, Yang LP, Chen GY. Influence of nonalcoholic fatty liver disease on response to antiviral treatment in patients with chronic hepatitis B: A meta-analysis. World J Hepatol 2024; 16(3): 465-476 [PMID: 38577526 DOI: 10.4254/wjh.v16.i3.465]
Corresponding Author of This Article
Gong-Ying Chen, MD, Professor, Department of Infectious and Hepatology Diseases, Affiliated Hospital of Hangzhou Normal University, No. 126 Wenzhou Road, Hangzhou 310015, Zhejiang Province, China. liuxingli0329@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Meta-Analysis
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/
Shi-Yi Liu, Lu-Ping Yang, Department of Medicine, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
Dian Wang, Department of Medicine, Hangzhou Normal University, Hangzhou 310011, Zhejiang Province, China
Jing Liu, Gong-Ying Chen, Department of Infectious and Hepatology Diseases, Affiliated Hospital of Hangzhou Normal University, Hangzhou 310015, Zhejiang Province, China
Co-first authors: Shi-Yi Liu and Dian Wang.
Author contributions: Liu SY and Wang D reviewed each article independently; Data were extracted from studies meeting both inclusion and exclusion criteria following a review of the entire contents of each paper; Chen GY as a third investigator, discussion, or revision to resolve any differences.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
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: Gong-Ying Chen, MD, Professor, Department of Infectious and Hepatology Diseases, Affiliated Hospital of Hangzhou Normal University, No. 126 Wenzhou Road, Hangzhou 310015, Zhejiang Province, China. liuxingli0329@163.com
Received: October 24, 2023 Peer-review started: October 24, 2023 First decision: January 5, 2024 Revised: January 26, 2024 Accepted: February 28, 2024 Article in press: February 28, 2024 Published online: March 27, 2024
ARTICLE HIGHLIGHTS
Research background
There is a surge in patients having chronic hepatitis B (CHB) with nonalcoholic fatty liver disease (NAFLD). However, there are several conflicting observations in the literature on the effect of NAFLD in patients with CHB who are under antiviral treatment.
Research motivation
A meta-analysis was conducted to explore the impact of NAFLD on the treatment response in antiviral-treated patients with CHB.
Research objectives
The complexity of liver disease has increased, which poses new challenges in clinical diagnosis and treatment. In this scenario, a specific antiviral strategy is warranted for patients having CHB with NAFLD.
Research methods
This is a systematic review and meta-analysis that compared the response to antiviral treatment between patients with CHB alone and those with CHB and hepatic steatosis. We investigated these two groups in terms of biochemical responses, serological responses, and virological responses to the incidence of hepatocellular carcinoma (HCC).
Research results
In the meta-analysis, hepatic steatosis lowered the biochemical response until 48 wk and 96 wk and serological response until 96 wk to antiviral treatment in patients with CHB. On the contrary, virological responses until 48 wk and 96 wk, serological response until 48 wk, and the incidence of HCC until 5 years were not significantly different in patients with hepatic steatosis than in those without the condition. Our finding signifies that hepatic steatosis lowers the response to antiviral therapy in patients with CHB.
Research conclusions
Hepatic steatosis lowers the biochemical response to antiviral treatment in patients with CHB. This condition might become a hazard factor of disease progression when present in patients affected by HBV.
Research perspectives
The significant effect of hepatic steatosis on the therapeutic response in patients with CHB should be demonstrated through larger prospective studies.
