Influence of nonalcoholic fatty liver disease on the therapeutic effect of nucleoside (acid) analogs for hepatitis B virus

Figure 1 Flow chart of the chronic hepatitis B subjects enrolled in the study. A total of 1405 adults with chronic hepatitis B (CHB) were assessed during the study period, and 465 met the inclusion criteria. Among those who received antiviral therapy with NAs, 139 subjects obtained complete virological response, 326 subjects got partial virological response (PVR), and the risk factors of PVR were observed. Subsequently, to verify the relationship between nonalcoholic fatty liver disease coexisting with CHB and virological response, we conducted a dynamic analysis of viral response to NAs antiviral treatment from patients with hepatitis B virus DNA high viral load and low viral load. CHB: Chronic hepatitis B; NAs: Nucleos(t)ide analogues; NAFLD: Nonalcoholic fatty liver disease; ETV: Entecavir; TDF: Tenofovir disoproxil fumarate; TAF: Tenofovir alafenamide fumarate.

Figure 2 Dynamics of virological response to antiviral therapy over time in chronic hepatitis B patients with and without nonalcoholic fatty liver disease. A: Dynamic change trend of hepatitis B virus viral load; B: Cumulative negative conversion rate of hepatitis B virus. NAFLD: Nonalcoholic fatty liver disease; CHB: Chronic hepatitis B; HBV: Hepatitis B virus; HBV DNA: Hepatitis B virus deoxyribonucleic acid.

Figure 3 Biochemical response of chronic hepatitis B patients with and without nonalcoholic fatty liver disease by antiviral therapy at 24 months. A: Normalization rate of alanine aminotransferase (≤ 30 U/L and ≤ 19 U/L for males and females); B: Normalization rate of aspartate aminotransferase (≤ 40 U/L for males and females). NAFLD: Nonalcoholic fatty liver disease.

Figure 4 Virological response of chronic hepatitis B patients with and without nonalcoholic fatty liver disease at different antiviral treatment duration. A: Dynamic change trend of hepatitis B virus low viral load; B: Cumulative negative conversion rate of hepatitis B virus low viral load. NAFLD: Nonalcoholic fatty liver disease; HBV: Hepatitis B virus; HBV DNA: Hepatitis B virus deoxyribonucleic acid.

Figure 5 Virological response of chronic hepatitis B patients with different grades of nonalcoholic fatty liver disease at different antiviral treatment duration. Dynamic change trend of hepatitis B virus viral load. NAFLD: Nonalcoholic fatty liver disease; CHB: Chronic hepatitis B; HBV DNA: Hepatitis B virus deoxyribonucleic acid.