Emin Bodakci1 , Saba Kiremitci2 , Zeynep Melekoglu Ellik3 , Ozge Koc3 , Mesut Gumussoy3 , Volkan Yilmaz3 , Hale Gokcan3 , Atilla Halil Erhan4 , Sevinc Tugce Guvenir5 , Ramazan Erdem Er3 , Berna Savas2 , Ramazan Idılman3 22Department of Pathology, Ankara University School of Medicine, Ankara, Turkiye
3Department of Gastroenterology, Ankara University School of Medicine, Ankara, Turkiye
4Department of Biostatistics, Ankara University School of Medicine, Ankara, Turkiye
5Department of Gastroenterology, Batman Training and Research Hospital, Batman, Turkiye
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 pa-tients were enrolled.
Results: This study included 296 patients: 186 with chronic HBV in-fection 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 hep-atosteatosis. Thirty-two patients (11%) achieved HBsAg loss during the follow-up period; 72% had HBsAg seroconversion to anti-HBs. Multi-variable 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.
