Emin Bodakci1 , Saba Kiremitci2 , Zeynep Melekoglu Ellik3 , Ozge Koc3 , Mesut Gumussoy3 , Volkan Yilmaz3 , Sevinc Tugce Guvenir4 , Ramazan Erdem Er3 , Hale Gokcan3 , Berna Savas2 , Atilla Halil Erhan5 , Ramazan Idılman3 2Department of Pathology, Ankara University, Ankara, Türkiye
33Department of Gastroenterology, Ankara University, Ankara, Türkiye
4Department of Gastroenterology, Batman Training and Research Hospital, Batman, Türkiye
5Department of Biostatistics, Ankara University, Ankara, Türkiye
Abstract
Background and Aim: The present study aimed to determine the effect of hepatic steatosis, as detected by liver biopsy, on Hepatitis B surface antigen (HbsAg) seroclearance and disease progression in patients infected with hepatitis B virus (HBV).
Material and Methods: Patients with chronic HBV infection and chronic hepatitis B (CHB) from an existing cohort of HBV-infected patients were enrolled.
Results: This study included 296 patients: 186 with chronic HBV infection and 110 with CHB. Patients with chronic HBV infection were older (p=0.006), and exhibited a higher prevalence of wild-type mutants (p<0.001). At the baseline liver biopsy, 31% of the patients had hepatosteatosis.
Thirty-two patients (11%) achieved HBsAg loss during the follow-up period; 72% had HBsAg seroconversion to anti-HBs. Multivariable Cox regression showed that the stage of HBV disease (chronic HBV infection vs. CHB) (Hazard ratio [HR]: 6.385, Confidence interval [CI]: 1.513–26.941, p=0.012) and grading of hepatosteatosis at baseline liver biopsy (HR: 4.699, CI: 1.662–13.286, p=0.004) were predictors of HBsAg seroclearance.
Conclusion: hepatic steatosis was associated with a functional cure for chronic HBV infection; however, it also causes disease progression in HBV-infected patients.
