Association of Metabolic Comorbidities With Fibrosis Severity and Fibrosis Regression in Patients With Chronic Hepatitis B.

IF 11.6 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Clinical Gastroenterology and Hepatology Pub Date : 2025-05-15 DOI:10.1016/j.cgh.2025.04.024

Lisa M van Velsen, Lesley A Patmore, Jordan J Feld, Henry L Y Chan, Teerha Piratvisuth, Rong-Nan Chien, Edo J Dongelmans, Vedran Pavlovic, Leland J Yee, Willem Pieter Brouwer, Audrey Lau, Bettina E Hansen, Maria Buti, Qing Xie, Keyur Patel, Scott K Fung, Harry L A Janssen, Milan J Sonneveld

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引用次数: 0

Abstract

Background and aims: The presence of metabolic comorbidities is associated with a higher risk of liver-related events in chronic hepatitis B (CHB) patients. However, the association between presence of metabolic comorbidities and the severity of biopsy-proven liver fibrosis is yet unknown.

Methods: Data from CHB patients from 2 tertiary clinics and 8 clinical trials was analyzed. We studied the association between presence of metabolic comorbidities with severity of liver fibrosis in untreated patients, and with fibrosis regression or progression in biopsies taken after initiation of antiviral therapy.

Results: We analyzed biopsies from 3179 untreated CHB patients. Median age was 37 years, 57.6% were hepatitis B e antigen positive, with median hepatitis B virus DNA of 7.30 logIU/mL. Overweight (29.4% vs 19.0%; P < .001), hypertension (40.7% vs 23.2%; P < .001), diabetes (42.2% vs 23.6%; P < .001), and dyslipidemia (42.9 vs 23.6%; P < .001) were associated with a higher risk of advanced fibrosis, with the highest risk observed in patients with multiple comorbidities. Findings were consistent in multivariable analysis (1 comorbidity: adjusted odds ratio [aOR], 1.115; ≥2 comorbidities: aOR, 1.627; P = .006). Regression to nonadvanced fibrosis, after treatment initiation, was more often observed in patients without metabolic comorbidities (43.1%), compared with patients with 1 (31.6%) or ≥2 comorbidities (17.0%) (P = .005). Findings were consistent in multivariable analysis (1 comorbidity: aOR, 0.792; ≥2 comorbidities: aOR, 0.260; P = .025). The risk of progression to advanced fibrosis was highest in patients with ≥2 comorbidities (14.3% vs 4.6%; P = .001).

Conclusions: Presence of metabolic comorbidities in untreated CHB patients is associated with more severe liver fibrosis and, after initiation of antiviral therapy, with less fibrosis regression and a higher risk of fibrosis progression.

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慢性乙型肝炎患者代谢合并症与纤维化严重程度和纤维化消退的关系

背景与目的：慢性乙型肝炎（CHB）患者代谢合并症的存在与肝脏相关事件的高风险相关。然而，代谢合并症的存在与活检证实的肝纤维化严重程度之间的关系尚不清楚。方法：对2家三级医院和8项临床试验的慢性乙型肝炎患者资料进行分析。我们研究了代谢合并症与未治疗患者肝纤维化严重程度之间的关系，以及抗病毒治疗（AVT）开始后活检中纤维化消退或进展之间的关系。结果：我们分析了3179例未经治疗的慢性乙型肝炎患者的活检。中位年龄为37岁，HBeAg阳性57.6%，中位HBV DNA为7.30 logIU/mL。结论：未经治疗的CHB患者存在代谢合并症与更严重的肝纤维化有关，并且在开始AVT后，纤维化消退较少，纤维化进展的风险更高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Gastroenterology and Hepatology 医学-胃肠肝病学

CiteScore

16.90

自引率

4.80%

发文量

903

审稿时长

22 days

期刊介绍： Clinical Gastroenterology and Hepatology (CGH) is dedicated to offering readers a comprehensive exploration of themes in clinical gastroenterology and hepatology. Encompassing diagnostic, endoscopic, interventional, and therapeutic advances, the journal covers areas such as cancer, inflammatory diseases, functional gastrointestinal disorders, nutrition, absorption, and secretion. As a peer-reviewed publication, CGH features original articles and scholarly reviews, ensuring immediate relevance to the practice of gastroenterology and hepatology. Beyond peer-reviewed content, the journal includes invited key reviews and articles on endoscopy/practice-based technology, health-care policy, and practice management. Multimedia elements, including images, video abstracts, and podcasts, enhance the reader's experience. CGH remains actively engaged with its audience through updates and commentary shared via platforms such as Facebook and Twitter.