Metabolic dysfunction-associated fatty liver disease increases risk of adverse outcomes in patients with chronic hepatitis B.

Autor:	van Kleef LA; Department of Gastroenterology and Hepatology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands., Choi HSJ; Toronto Centre for Liver Disease, University Health Network, Toronto, Canada., Brouwer WP; Department of Gastroenterology and Hepatology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands., Hansen BE; Toronto Centre for Liver Disease, University Health Network, Toronto, Canada., Patel K; Toronto Centre for Liver Disease, University Health Network, Toronto, Canada., de Man RA; Department of Gastroenterology and Hepatology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands., Janssen HLA; Toronto Centre for Liver Disease, University Health Network, Toronto, Canada., de Knegt RJ; Department of Gastroenterology and Hepatology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands., Sonneveld MJ; Department of Gastroenterology and Hepatology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands.
Jazyk:	angličtina
Zdroj:	JHEP reports : innovation in hepatology [JHEP Rep] 2021 Aug 08; Vol. 3 (5), pp. 100350. Date of Electronic Publication: 2021 Aug 08 (Print Publication: 2021).
DOI:	10.1016/j.jhepr.2021.100350
Abstrakt:	Background & Aims: A recent consensus document has defined metabolic dysfunction-associated fatty liver disease (MAFLD) as hepatic steatosis together with overweight, diabetes, and/or a combination of other metabolic risk factors. The clinical relevance of this novel diagnosis is unknown among patients with chronic hepatitis B (CHB). We studied the association between MAFLD (with or without steatohepatitis) and adverse clinical outcomes in patients with CHB. Methods: We performed a retrospective long-term follow-up cohort study at 2 tertiary hospitals in patients with CHB who underwent liver biopsy. Biopsies were reassessed for steatosis, degree of fibrosis, and presence of steatohepatitis. Associations with event-free hepatocellular carcinoma (HCC)-free and transplant-free survival were explored. Results: In our cohort, 1076 patients were included, median follow-up was 9.8 years (25th-75th percentile: 6.6-14.0), and 107 events occurred in 78 patients, comprising death (n = 43), HCC (n = 36), liver decompensation (n = 21), and/or liver transplantation (n = 7). MAFLD was present in 296 (27.5%) patients and was associated with reduced event-free (adjusted hazard ratio [aHR] 2.00, 95% CI 1.26-3.19), HCC-free (aHR 1.93, 95% CI 1.17-3.21), and transplant-free survival (aHR 1.80, 95% CI 0.98-3.29) in multivariable analysis. Among patients with MAFLD, the presence of steatohepatitis ( p  = 0.95, log-rank test) was not associated with adverse outcomes. Conclusions: The presence of MAFLD in patients with CHB was associated with an increased risk for liver-related clinical events and death. Among patients with MAFLD, steatohepatitis did not increase the risk of adverse outcomes. Our findings highlight the importance of metabolic dysfunction in patients with CHB. Lay Summary: Recently, metabolic dysfunction-associated fatty liver disease (MAFLD) has been defined as fatty liver disease with signs of metabolic dysfunction. Among patients with chronic hepatitis B, MAFLD was associated with liver-related events and death. Metabolic health assessment should be encouraged among patients with chronic hepatitis B, especially in those with fatty liver disease. Competing Interests: MJS has received speaker's fees and research support from Fujirebio and has received grants from Gilead. KP consults for, advises, and received grants from Gilead. HLAJ received grants from Abbvie, Arbutus, Bristol Myers, Squibb, Gilead Sciences, Janssen, Merck, and Roche and is a consultant for Aligos, Arbutus, Arena, Eiger, Enyo, Gilead Sciences, GlaxoSmithKline, Janssen, Merck, Regulus, Roche, VBI Vaccines (Variation Biotechnologies), Vir Biotechnology Inc., and Viroclinics. RdK is a speaker for Echosens, consultant for AbbVie, and received grants from Abbvie, Gilead, and Janssen. The remaining authors report no relevant conflicts. Please refer to the accompanying ICMJE disclosure forms for further details. (© 2021 The Authors.)
Databáze:	MEDLINE
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