中文｜English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 40 Issue 12
Dec.  2024
Turn off MathJax
Article Contents
Article Navigation >  Journal of Clinical Hepatology  > 2024  >  40(12): 2499-2504

Research advances in chronic hepatitis B with metabolic dysfunction-associated steatotic liver disease

DOI: 10.12449/JCH241221

  • Peking University People’s Hospital，Peking University Hepatology Institute，Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases，Beijing International Cooperation Base for Science and Technology on NAFLD Diagnosis，Beijing 100044，China

Research funding:

National Natural Science Foundation of China (82170584);

Beijing Natural Science Foundation (7242151);

Qimin Plan 

More Information
  • Corresponding author: LIU Feng， liu1116m@sina.com （ORCID： 0000-0002-0316-4938）
  • Received Date: 2024-03-28
  • Accepted Date: 2024-05-28
  • Published Date: 2024-12-25
    Abstract
  • Chronic hepatitis B （CHB） and fatty liver disease are common chronic liver diseases in China. With the changes in lifestyle， the number of patients with CHB and metabolic dysfunction-associated steatotic liver disease （MASLD） is increasing year by year. Both CHB and MASLD may lead to adverse events such as liver cirrhosis and hepatocellular carcinoma （HCC）. The pathophysiological course of the liver during the coexistence of the two diseases may be different from the state of each disease alone， and consequently HBV replication may exist， affecting HBsAg seroclearance and antiviral therapy and increasing the risk of adverse events including hepatic fibrosis and HCC. It is clear that these problems will be of great significance to the monitoring， treatment， and prognosis of such patients. Therefore， this article briefly reviews the latest research advances in these problems.

     

    • FullText(HTML)
  • loading
    • References(58)
  • [1]
    ZHANG XM, MA XQ, XU ZJ, et al. Effect of drug-resistant mutations in reverse transcriptase region of hepatitis B virus on the level of serum hepatitis B surface antigen[J/CD]. Chin J Exp Clin Infect Dis(Electronic Edition), 2023, 17( 5): 324- 332. DOI: 10.3877/cma.j.issn.1674-1358.2023.05.006.

    张小曼, 马筱秋, 许正锯, 等. 乙型肝炎病毒逆转录酶区耐药突变对血清乙型肝炎病毒表面抗原水平的影响[J/CD]. 中华实验和临床感染病杂志(电子版), 2023, 17( 5): 324- 332. DOI: 10.3877/cma.j.issn.1674-1358.2023.05.006.
    [2]
    COLLABORATORS PO. Global prevalence, cascade of care, and prophylaxis coverage of hepatitis B in 2022: A modelling study[J]. Lancet Gastroenterol Hepatol, 2023, 8( 10): 879- 907. DOI: 10.1016/S2468-1253(23)00197-8.
    [3]
    Infectious Disease Physicians Branch of Chinese Medical Doctor Association, National Clinical Research Center for Infectious Diseases. Expert consensus on whole-population management of hepatitis B virus infection(2023)[J]. Chin J Clin Infect Dis, 2024, 17( 1): 1- 13. DOI: 10.3760/cma.j.issn.1674-2397.2024.01.001.

    中国医师协会感染科医师分会, 国家感染性疾病临床医学研究中心. 乙型肝炎全人群管理专家共识(2023)[J]. 中华临床感染病杂志, 2024, 17( 1): 1- 13. DOI: 10.3760/cma.j.issn.1674-2397.2024.01.001.
    [4]
    RIAZI K, AZHARI H, CHARETTE JH, et al. The prevalence and incidence of NAFLD worldwide: A systematic review and meta-analysis[J]. Lancet Gastroenterol Hepatol, 2022, 7( 9): 851- 861. DOI: 10.1016/S2468-1253(22)00165-0.
    [5]
    ZHOU JH, ZHOU F, WANG WX, et al. Epidemiological features of NAFLD from 1999 to 2018 in China[J]. Hepatology, 2020, 71( 5): 1851- 1864. DOI: 10.1002/hep.31150.
    [6]
    YANG M, WEI L. Impact of NAFLD on the outcome of patients with chronic hepatitis B in Asia[J]. Liver Int, 2022, 42( 9): 1981- 1990. DOI: 10.1111/liv.15252.
    [7]
    SONG SJ, LAI JC, WONG GL, et al. Can we use old NAFLD data under the new MASLD definition?[J]. J Hepatol, 2024, 80( 2): e54- e56. DOI: 10.1016/j.jhep.2023.07.021.
    [8]
    SHI JP, FAN JG, WU R, et al. Prevalence and risk factors of hepatic steatosis and its impact on liver injury in Chinese patients with chronic hepatitis B infection[J]. J Gastroenterol Hepatol, 2008, 23( 9): 1419- 1425. DOI: 10.1111/j.1440-1746.2008.05531.x.
    [9]
    WANG MM, WANG GS, SHEN F, et al. Hepatic steatosis is highly prevalent in hepatitis B patients and negatively associated with virological factors[J]. Dig Dis Sci, 2014, 59( 10): 2571- 2579. DOI: 10.1007/s10620-014-3180-9.
    [10]
    ZHOU R, YANG LP, ZHANG BB, et al. Clinical impact of hepatic steatosis on chronic hepatitis B patients in Asia: A systematic review and meta-analysis[J]. J Viral Hepat, 2023, 30( 10): 793- 802. DOI: 10.1111/jvh.13872.
    [11]
    SETO WK. Chronic hepatitis B and metabolic risk factors: A call for rigorous longitudinal studies[J]. World J Gastroenterol, 2019, 25( 3): 282- 286. DOI: 10.3748/wjg.v25.i3.282.
    [12]
    YILMAZ B, KOKLU S, BUYUKBAYRAM H, et al. Chronic hepatitis B associated with hepatic steatosis, insulin resistance, necroinflammation and fibrosis[J]. Afr Health Sci, 2015, 15( 3): 714- 718. DOI: 10.4314/ahs.v15i3.3.
    [13]
    SHI YW, YANG RX, FAN JG. Chronic hepatitis B infection with concomitant hepatic steatosis: Current evidence and opinion[J]. World J Gastroenterol, 2021, 27( 26): 3971- 3983. DOI: 10.3748/wjg.v27.i26.3971.
    [14]
    HUANG JF, JING ML, WANG CY, et al. The impact of hepatitis B virus infection status on the prevalence of nonalcoholic fatty liver disease: A population-based study[J]. J Med Virol, 2020, 92( 8): 1191- 1197. DOI: 10.1002/jmv.25621.
    [15]
    CHENG YL, WANG YJ, KAO WY, et al. Inverse association between hepatitis B virus infection and fatty liver disease: A large-scale study in populations seeking for check-up[J]. PLoS One, 2013, 8( 8): e72049. DOI: 10.1371/journal.pone.0072049.
    [16]
    WONG VW, WONG GL, CHU WC, et al. Hepatitis B virus infection and fatty liver in the general population[J]. J Hepatol, 2012, 56( 3): 533- 540. DOI: 10.1016/j.jhep.2011.09.013.
    [17]
    CHEN JY, WANG JH, LIN CY, et al. Lower prevalence of hypercholesterolemia and hyperglyceridemia found in subjects with seropositivity for both hepatitis B and C strains independently[J]. J Gastroenterol Hepatol, 2010, 25( 11): 1763- 1768. DOI: 10.1111/j.1440-1746.2010.06300.x.
    [18]
    HUANG CY, LU CW, LIU YL, et al. Relationship between chronic hepatitis B and metabolic syndrome: A structural equation modeling approach[J]. Obesity, 2016, 24( 2): 483- 489. DOI: 10.1002/oby.21333.
    [19]
    ADOLPH TE, GRANDER C, GRABHERR F, et al. Adipokines and non-alcoholic fatty liver disease: Multiple interactions[J]. Int J Mol Sci, 2017, 18( 8): 1649. DOI: 10.3390/ijms18081649.
    [20]
    ZHANG JB, LIN SZ, JIANG DX, et al. Chronic hepatitis B and non-alcoholic fatty liver disease: Conspirators or competitors?[J]. Liver Int, 2020, 40( 3): 496- 508. DOI: 10.1111/liv.14369.
    [21]
    KIM K, KIM KH, KIM HH, et al. Hepatitis B virus X protein induces lipogenic transcription factor SREBP1 and fatty acid synthase through the activation of nuclear receptor LXRalpha[J]. Biochem J, 2008, 416( 2): 219- 230. DOI: 10.1042/BJ20081336.
    [22]
    LI J, LIANG X, JIANG J, et al. PBMC transcriptomics identifies immune-metabolism disorder during the development of HBV-ACLF[J]. Gut, 2022, 71( 1): 163- 175. DOI: 10.1136/gutjnl-2020-323395.
    [23]
    WU YL, PENG XE, ZHU YB, et al. Hepatitis B virus X protein induces hepatic steatosis by enhancing the expression of liver fatty acid binding protein[J]. J Virol, 2016, 90( 4): 1729- 1740. DOI: 10.1128/JVI.02604-15.
    [24]
    QIU PS, WANG HZ, ZHANG MN, et al. FATP2-targeted therapies-A role beyond fatty liver disease[J]. Pharmacol Res, 2020, 161: 105228. DOI: 10.1016/j.phrs.2020.105228.
    [25]
    PEREZ VM, GABELL J, BEHRENS M, et al. Deletion of fatty acid transport protein 2(FATP2) in the mouse liver changes the metabolic landscape by increasing the expression of PPARα-regulated genes[J]. J Biol Chem, 2020, 295( 17): 5737- 5750. DOI: 10.1074/jbc.RA120.012730.
    [26]
    LU Y, YANG XY, KUANG Q, et al. HBx induced upregulation of FATP2 promotes the development of hepatic lipid accumulation[J]. Exp Cell Res, 2023, 430( 1): 113721. DOI: 10.1016/j.yexcr.2023.113721.
    [27]
    PELEG N, ISSACHAR A, SNEH ARBIB O, et al. Liver steatosis is a strong predictor of mortality and cancer in chronic hepatitis B regardless of viral load[J]. JHEP Rep, 2019, 1( 1): 9- 16. DOI: 10.1016/j.jhepr.2019.02.002.
    [28]
    HUI RWH, SETO WK, CHEUNG KS, et al. Inverse relationship between hepatic steatosis and hepatitis B viremia: Results of a large case-control study[J]. J Viral Hepat, 2018, 25( 1): 97- 104. DOI: 10.1111/jvh.12766.
    [29]
    CHU CM, LIN DY, LIAW YF. Does increased body mass index with hepatic steatosis contribute to seroclearance of hepatitis B virus(HBV) surface antigen in chronic HBV infection?[J]. Int J Obes(Lond), 2007, 31( 5): 871- 875. DOI: 10.1038/sj.ijo.0803479.
    [30]
    CHU CM, LIN DY, LIAW YF. Clinical and virological characteristics post HBsAg seroclearance in hepatitis B virus carriers with hepatic steatosis versus those without[J]. Dig Dis Sci, 2013, 58( 1): 275- 281. DOI: 10.1007/s10620-012-2343-9.
    [31]
    MAK LY, HUI RW, FUNG J, et al. Diverse effects of hepatic steatosis on fibrosis progression and functional cure in virologically quiescent chronic hepatitis B[J]. J Hepatol, 2020, 73( 4): 800- 806. DOI: 10.1016/j.jhep.2020.05.040.
    [32]
    SCHUSTER S, CABRERA D, ARRESE M, et al. Triggering and resolution of inflammation in NASH[J]. Nat Rev Gastroenterol Hepatol, 2018, 15( 6): 349- 364. DOI: 10.1038/s41575-018-0009-6.
    [33]
    ZHANG RN, PAN Q, ZHANG Z, et al. Saturated fatty acid inhibits viral replication in chronic hepatitis B virus infection with nonalcoholic Fatty liver disease by toll-like receptor 4-mediated innate immune response[J]. Hepat Mon, 2015, 15( 5): e27909. DOI: 10.5812/hepatmon.15(5)2015.27909.
    [34]
    KHANMOHAMMADI S, KUCHAY MS. Toll-like receptors and metabolic(dysfunction)-associated fatty liver disease[J]. Pharmacol Res, 2022, 185: 106507. DOI: 10.1016/j.phrs.2022.106507.
    [35]
    TONG X, SONG Y, YIN SX, et al. Clinical impact and mechanisms of hepatitis B virus infection concurrent with non-alcoholic fatty liver disease[J]. Chin Med J, 2022, 135( 14): 1653- 1663. DOI: 10.1097/CM9.0000000000002310.
    [36]
    SETO WK, HUI RWH, MAK LY, et al. Association between hepatic steatosis, measured by controlled attenuation parameter, and fibrosis burden in chronic hepatitis B[J]. Clin Gastroenterol Hepatol, 2018, 16( 4): 575- 583. DOI: 10.1016/j.cgh.2017.09.044.
    [37]
    KHALILI M, KLEINER DE, KING WC, et al. Hepatic steatosis and steatohepatitis in a large North American cohort of adults with chronic hepatitis B[J]. Am J Gastroenterol, 2021, 116( 8): 1686- 1697. DOI: 10.14309/ajg.0000000000001257.
    [38]
    HUANG Y, GAN QY, LAI RT, et al. Application of fatty liver inhibition of progression algorithm and steatosis, activity, and fibrosis score to assess the impact of non-alcoholic fatty liver on untreated chronic hepatitis B patients[J]. Front Cell Infect Microbiol, 2021, 11: 733348. DOI: 10.3389/fcimb.2021.733348.
    [39]
    CHAN AW, WONG GL, CHAN HY, et al. Concurrent fatty liver increases risk of hepatocellular carcinoma among patients with chronic hepatitis B[J]. J Gastroenterol Hepatol, 2017, 32( 3): 667- 676. DOI: 10.1111/jgh.13536.
    [40]
    LIN M, GAO BW, PENG MN, et al. Metabolic dysfunction-associated steatotic liver disease increases hepatocellular carcinoma risk in chronic hepatitis B patients: A retrospective cohort study[J]. Front Physiol, 2024, 15: 1347459. DOI: 10.3389/fphys.2024.1347459.
    [41]
    HAN CL, TIAN BW, YANG CC, et al. The association of fatty liver and risk of hepatocellular carcinoma in HBV or HCV infected individuals: A systematic review and meta-analysis[J]. Expert Rev Gastroenterol Hepatol, 2023, 17( 2): 189- 198. DOI: 10.1080/17474124.2023.2166930.
    [42]
    LEE MH, CHEN YT, HUANG YH, et al. Chronic viral hepatitis B and C outweigh MASLD in the associated risk of cirrhosis and HCC[J]. Clin Gastroenterol Hepatol, 2024, 22( 6): 1275- 1285. DOI: 10.1016/j.cgh.2024.01.045.
    [43]
    LIM CT, GOH GBB, LI HH, et al. Presence of hepatic steatosis does not increase the risk of hepatocellular carcinoma in patients with chronic hepatitis B over long follow-up[J]. Microbiol Insights, 2020, 13: 1178636120918878. DOI: 10.1177/1178636120918878.
    [44]
    MAK LY, HUI RW, FUNG J, et al. Reduced hepatic steatosis is associated with higher risk of hepatocellular carcinoma in chronic hepatitis B infection[J]. Hepatol Int, 2021, 15( 4): 901- 911. DOI: 10.1007/s12072-021-10218-2.
    [45]
    HSUEH RC, WU WJ, LIN CL, et al. Impact of PNPLA3 p.I148M and hepatic steatosis on long-term outcomes for hepatocellular carcinoma and HBsAg seroclearance in chronic hepatitis B[J]. J Hepatocell Carcinoma, 2022, 9: 301- 313. DOI: 10.2147/JHC.S355540.
    [46]
    STREBA LA, VERE CC, ROGOVEANU I, et al. Nonalcoholic fatty liver disease, metabolic risk factors, and hepatocellular carcinoma: An open question[J]. World J Gastroenterol, 2015, 21( 14): 4103- 4110. DOI: 10.3748/wjg.v21.i14.4103.
    [47]
    JIN X, CHEN YP, YANG YD, et al. Association between hepatic steatosis and entecavir treatment failure in Chinese patients with chronic hepatitis B[J]. PLoS One, 2012, 7( 3): e34198. DOI: 10.1371/journal.pone.0034198.
    [48]
    ZHANG SY, ZHANG XX, JIN HM, et al. Adverse effect of nonalcoholic fatty liver disease on the therapeutic response in patients with chronic hepatitis B[J]. J Clin Transl Hepatol, 2023, 11( 1): 67- 75. DOI: 10.14218/JCTH.2022.00066.
    [49]
    RUI FJ, GARCIA E, HU XY, et al. Antiviral therapy response in patients with chronic hepatitis B and fatty liver: A systematic review and meta-analysis[J]. J Viral Hepat, 2024, 31( 7): 372- 382. DOI: 10.1111/jvh.13942.
    [50]
    LI J, LE AK, CHAUNG KT, et al. Fatty liver is not independently associated with the rates of complete response to oral antiviral therapy in chronic hepatitis B patients[J]. Liver Int, 2020, 40( 5): 1052- 1061. DOI: 10.1111/liv.14415.
    [51]
    ZHU LY, WANG YG, WEI LQ, et al. The effects of the insulin resistance index on the virologic response to entecavir in patients with HBeAg-positive chronic hepatitis B and nonalcoholic fatty liver disease[J]. Drug Des Devel Ther, 2016, 10: 2739- 2744. DOI: 10.2147/DDDT.S114761.
    [52]
    ZHANG MY, CHEN SY, WU XN, et al. Persistent steatosis correlates with decreased fibrosis regression during anti-HBV treatment in patients with chronic HBV infection[J]. J Med Virol, 2023, 95( 10): e29156. DOI: 10.1002/jmv.29156.
    [53]
    MAK LY, SETO WK, HUI RW, et al. Fibrosis evolution in chronic hepatitis B e antigen-negative patients across a 10-year interval[J]. J Viral Hepat, 2019, 26( 7): 818- 827. DOI: 10.1111/jvh.13095.
    [54]
    GENG N, NI WJ, RUI FJ, et al. Chronic hepatitis B virus infection and metabolic associated fatty liver disease: The known and unknown aspects[J]. J Clin Hepatol, 2024, 40( 3): 441- 445. DOI: 10.12449/JCH240301.

    耿楠, 倪文婧, 芮法娟, 等. 慢性HBV感染与代谢相关脂肪性肝病: 已知与未知[J]. 临床肝胆病杂志, 2024, 40( 3): 441- 445. DOI: 10.12449/JCH240301.
    [55]
    YOUNOSSI ZM, COREY KE, LIM JK. AGA clinical practice update on lifestyle modification using diet and exercise to achieve weight loss in the management of nonalcoholic fatty liver disease: Expert review[J]. Gastroenterology, 2021, 160( 3): 912- 918. DOI: 10.1053/j.gastro.2020.11.051.
    [56]
    Resmetirom(Rezdiffra) for metabolic dysfunction-associated steatohepatitis[J]. Med Lett Drugs Ther, 2024, 66( 1701): 65- 66. DOI: 10.58347/tml.2024.1701a.
    [57]
    FRANCQUE SM, BEDOSSA P, RATZIU V, et al. A randomized, controlled trial of the pan-PPAR agonist lanifibranor in NASH[J]. N Engl J Med, 2021, 385( 17): 1547- 1558. DOI: 10.1056/NEJMoa2036205.
    [58]
    KIM JT, PARK MS, NAM TS, et al. Multiple cerebral arterial stenosis associated with hepatitis B virus infection[J]. J Clin Neurol, 2011, 7( 1): 40- 42. DOI: 10.3988/jcn.2011.7.1.40.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索
    Get Citation
    PDF
    XML

    Article Metrics

    Article views (105) PDF downloads(25) Cited by()
    Proportional views
    Related
        

    The first journal specializing in hepatobiliary and pancreatic diseases in China

    Supervisor：Ministry of Education of the People's Republic of China

    Sponsor：Jilin University

    Academic Support: Chinese Society of Hepatology，Chinese Medical Association

    Address: 461 Xinjiang Road, Changchun

    Submit：0431-88782044

    Peer review：0431-88783542

    Email：lcgdb@vip.163.com

    About Journal

    Submission Guideline

    Journal Online

    Hepatobiliary College

    Guidelines

    YesterdayIP[]YesterdayPV[]TodayIP[]TodayPV[]Online[]

    Website Design © 2020 Editorial Board of Journal of Clinical Hepatology 吉ICP备10000617号-1 Supported by: Beijing Renhe Information Technology Co. Ltd  

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return