Tan YW, Wang JM, Zhou XB. Baseline hepatocyte ballooning is a risk factor for adverse events in patients with chronic hepatitis B complicated with nonalcoholic fatty liver disease. World J Hepatol 2023; 15(2): 237-254 [PMID: 36926239 DOI: 10.4254/wjh.v15.i2.237]
Corresponding Author of This Article
You-Wen Tan, MD, Chief Doctor, Professor, Department of Hepatology, The Third Hospital of Zhenjiang Affiliated Jiangsu University, No. 300 Daijiamen, Runzhou Distinct, Zhenjiang 212003, Jiangsu Province, China. tyw915@sina.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Feb 27, 2023; 15(2): 237-254 Published online Feb 27, 2023. doi: 10.4254/wjh.v15.i2.237
Baseline hepatocyte ballooning is a risk factor for adverse events in patients with chronic hepatitis B complicated with nonalcoholic fatty liver disease
You-Wen Tan, Jia-Min Wang, Xing-Bei Zhou
You-Wen Tan, Jia-Min Wang, Xing-Bei Zhou, Department of Hepatology, The Third Hospital of Zhenjiang Affiliated Jiangsu University, Zhenjiang 212003, Jiangsu Province, China
Author contributions: YW Tan and JM Wang contribute equally to research; YW Tan and XB Zhou designed the research; YW Tan and JM Wang collected and analyzed the data, and drafted the manuscript; YW Tan performed the liver pathological evaluations; YW Tan and XB Zhou wrote and revised the manuscript; All authors have read and approved the final version to be published.
Supported bythe Social Development Project of Jiangsu Province, China, No. BE2020775; Chinese Federation of Public Health foundation, No. GWLM202002.
Institutional review board statement: This study was approved by the ethics committee of The Third People’s Hospital Affiliated to Zhenjiang, Jiangsu University.
Conflict-of-interest statement: The authors declare that there is no relevant conflict of interest.
Data sharing statement: The datasets used or analyzed during the current study are available from the corresponding author on reasonable request.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: You-Wen Tan, MD, Chief Doctor, Professor, Department of Hepatology, The Third Hospital of Zhenjiang Affiliated Jiangsu University, No. 300 Daijiamen, Runzhou Distinct, Zhenjiang 212003, Jiangsu Province, China. tyw915@sina.com
Received: November 22, 2022 Peer-review started: November 22, 2022 First decision: December 10, 2022 Revised: December 14, 2022 Accepted: January 17, 2023 Article in press: January 17, 2023 Published online: February 27, 2023 Processing time: 93 Days and 15.6 Hours
ARTICLE HIGHLIGHTS
Research background
Chronic hepatitis B (CHB) virus infection and nonalcoholic fatty liver disease (NAFLD) are important causes of liver-related complications and death. With the increasing prevalence of NAFLD, the number of patients with combined NAFLD and hepatitis B virus (HBV) infection is also on the increase.
Research motivation
This study aimed to further explore the impact of NAFLD and the pathological changes confirmed by liver pathology in patients with chronic HBV infection.
Research objectives
To study the effect of NAFLD confirmed using liver pathology on the outcomes of long-term serious adverse events in patients with CHB virus infection.
Research methods
Among 456 cases of chronic HBV infection, 152 were confirmed by liver histology to have NAFLD, and 304 were simple chronic HBV infection. The incidence of serious clinical events at the follow-up endpoint was compared by Kaplan-Meier (K-M) survival analysis at baseline using propensity score matching balance parameters.
Research results
After a median follow-up of 70.5 mo, there were 34 cases of ultrasound-diagnosed cirrhosis and 10 cases of HCC. K-M survival analysis showed no significant difference in the occurrence of CHB complicated with NAFLD cirrhosis, and the cumulative incidence of HCC in the NAFLD group was higher than that in the non-NAFLD group (log-rank test, P < 0.05). Hepatocyte ballooning and severe liver fibrosis were also associated with an increased risk of HCC (log-rank test, all P < 0.05).
Research conclusions
Baseline hepatocyte ballooning is a risk factor for adverse events in patients with CHB complicated with NAFLD.
Research perspectives
Larger samples and more rigorous prospective studies are needed for further verification. The study cohort needs to be observed for a longer time, and the conclusion may change if this is done, in the study.
