Influence of nonalcoholic fatty liver disease on response to antiviral treatment in patients with chronic hepatitis B: A meta-analysis

Abstract

BACKGROUND

Although hepatitis B virus infection is the leading cause of chronic liver injury globally, nonalcoholic fatty liver disease (NAFLD) is gradually gaining attention as another major chronic liver disease. The number of patients having chronic hepatitis B (CHB) with concomitant hepatic steatosis has increased.

AIM

To analyze the effect of NAFLD on the response to antiviral treatment in patients with CHB.

METHODS

Relevant English studies were systematically searched across PubMed, EMBASE, Web of Science, and Cochrane Library until October 2023. Studies in which the treatment outcomes were compared between patients with CHB only and those with CHB and hepatic steatosis were included.

RESULTS

Of the 2502 retrieved studies, 11 articles were finally included. Biochemical response until 48 wk (OR = 0.87, 95%CI: 0.50–1.53, P = 0.000) and 96 wk (OR = 0.35, 95%CI: 0.24–0.53, P = 0.24) and virological response until 96 wk (OR = 0.80, 95%CI: 0.43–1.49, P = 0.097) were lower in patients with hepatic steatosis than in patients with CHB alone.

CONCLUSION

Hepatic steatosis lowers the biochemical response to antiviral treatment in patients with CHB.

Keywords: Nonalcoholic fatty liver disease; Hepatitis B virus; Antiviral treatment; effect; Meta-analysis

Core Tip: No consensus is available in the literature about which effect of nonalcoholic fatty liver disease on the response to antiviral treatment in patients with chronic hepatitis B (CHB). This is a systematic review and meta-analysis comparing the response to antiviral treatment between patients with CHB only and those with CHB and hepatic steatosis were included. We investigated these two groups in terms of biochemical responses, serological responses, virological responses the incidence of hepatocellular carcinoma.