Şebnem GÜRSOY, Kadri GÜVEN, Ahmet KARAMAN, Ömer ÖZBAKIR, Hatic KARAMAN, Muhammet Edip TORUN, Mustafa Alper YURCİ, Mehmet YÜCESOY, Mevlüt BAŞKOL, Işın SOYUER

Effect of hepatic steatosis on virological response to nucleos(t)ide analogs therapy in patients with chronic hepatitis B

To evaluate the impact of hepatic steatosis on the outcome of treatment in patients with chronic hepatitis B infection treated with oral antiviral therapy. Materials and methods: The study was designed in Erciyes University Medical Faculty Department of Gastroenterology. Patients who received oral antiviral therapy because of chronic hepatitis B were included in the study. Liver biopsy specimens were re-evaluated and classified according to Brunt’s steatosis classification. Virological response to oral antiviral therapy was compared between patients with and without steatosis. Results: One hundred and nineteen patients were included in the study, of which 36.1% had hepatic steatosis. Virological response rates were 81% and 85.5% in patients with steatosis and without steatosis, respectively. There was no statistically significant difference in virological response rate between patients with and without steatosis (p: 0.78). Median hepatic fibrosis values were 3 and 2 in patients with steatosis and without steatosis respectively (p: 0.01). Conclusion: Many studies have researched the prevalence and effect of steatosis on the liver in chronic hepatitis B. Although steatosis does not affect the outcome of treatment, it is not a rare condition in chronic hepatitis B.

Anahtar Kelimeler:

Key words: Hepatic steatosis, hepatitis B, viral response, antiviral therapy, nucleos(t)ide analogs, liver fibrosis

Effect of hepatic steatosis on virological response to nucleos(t)ide analogs therapy in patients with chronic hepatitis B

Keywords:

Key words: Hepatic steatosis, hepatitis B, viral response, antiviral therapy, nucleos(t)ide analogs, liver fibrosis,

PDF

___

Angulo P, Lindor KD. Non-alcoholic fatty liver disease. Journal of Gastroenterology and Hepatology 2002; 17 Suppl: S186–90.
an urban population in the United States: impact of ethnicity.
Hepatology 2004; 40: 1387–95.
Lavanchy D. Hepatitis B virus epidemiology, disease burden, treatment, and current and emerging prevention and control measures. J Viral Hepat 2004; 11: 97–107. 6. Oner S, Yapıcı G, Şaşmaz CT, Kurt AO, Buğdaycı R. Hepatitis B, hepatitis C, HIV, and VDRL seroprevalence of blood donors in Mersin, Turkey. Turk J Med Sci 2011; 41: 335–341.
Bondini S, Kallman J, Wheeler A, Prakash S, Gramlich T, Jondle DM et al. Impact of non-alcoholic fatty liver disease on chronic hepatitis B. Liver Int 2007; 27: 607–11.
Niederau C, Heintges T, Lange S, Goldmann G, Niederau CM, Mohr L et al. Long-term follow-up of HBeAg-positive patients treated with interferon alfa for chronic hepatitis B. N Engl J Med 1996; 334: 1422–7.
Knodell RG, Ishak KG, Black WC, Chen TS, Craig R, Kaplowitz N et al. Formulation and application of a numerical scoring system for assessing histological activity in asymptomatic chronic active hepatitis. Hepatology 1981; 1: 431–5.
Brunt EM, Janney CG, Di Biseeglie AM, Neuschwan der-Tetri BA, Bacon BR. Nonalcoholic steatohepatitis: a proposal for grading and staging the histological lesions. The American Journal of Gastroenterology 1999; 94: 2467–74.
Leandro G, Mangia A, Hui J, Fabris P, Rubbia-Brandt L, Colloredo G et al. Relationship between steatosis, inflammation, and fibrosis in chronic hepatitis C: a meta- analysis of individual patient data. Gastroenterology 2006; 130: 1636–42.
Minakari M, Molaei M, Shalmani HM, Alizadeh AH, Jazi AH, Naderi N et al. Liver steatosis in patients with chronic hepatitis B infection: host and viral risk factors. European Journal of Gastroenterology & Hepatology 2009; 21: 512–6.
Shi JP, Fan JG, Wu R, Gao XQ, Zhang L, Wang H et al. Prevalence and risk factors of hepatic steatosis and its impact on liver injury in Chinese patients with chronic hepatitis B infection. Journal of Gastroenterology and Hepatology 2008; 23: 1419–25.
Mi YQ, Liu YG, Xu L, Fan JG, Zhang H, Ping L et al. [Analysis of clinical and pathological features of chronic hepatitis B with hepatic steatosis]. Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese Journal of Hepatology, 2009; 17: 817–20.
Shi JP, Fan JG, Wu R, Gao XQ, Zhang L. [Viral and host causes of hepatosteatosis in Chinese patients with chronic hepatitis B]. Zhonghua shi yan he lin chuang bing du xue za zhi = Zhonghua shiyan he linchuang bingduxue zazhi = Chinese Journal of Experimental and Clinical Virology, 2008; 22: 324– 6.
Cindoruk M, Karakan T, Unal S. Hepatic steatosis has no impact on the outcome of treatment in patients with chronic hepatitis B infection. Journal of Clinical Gastroenterology 2007; 41: 513–7.
Machado MV, Oliveira AG, Cortez-Pinto H. Hepatic steatosis in hepatitis B virus infected patients: meta-analysis of risk factors and comparison with hepatitis C infected patients. J Gastroenterol Hepatol 2011; 26: 1361–7.
Petta S, Cammà C, Di Marco V, Macaluso FS, Maida M, Pizzolanti G et al. Hepatic steatosis and insulin resistance are associated with severe fibrosis in patients with chronic hepatitis caused by HBV or HCV infection. Liver Int 2011; 31: 507–15.
Berson A, De Beco V, Lettéron P, Robin MA, Moreau C, El Kahwaji J et al. Steatohepatitis-inducing drugs cause mitochondrial dysfunction and lipid peroxidation in rat hepatocytes. Gastroenterology 1998; 114: 764–74.
EASL Clinical Practice Guidelines: management of chronic hepatitis B. Journal of Hepatology 2009; 50: 227–42.