Hepatitis B virus infection combined with nonalcoholic fatty liver disease: Interaction and prognosis

Abstract

Hepatitis B virus (HBV) infection is still one kind of the infectious diseases that seriously threaten human health. Nonalcoholic fatty liver disease (NAFLD) has become the most common chronic liver disease worldwide. HBV infection complicated with NAFLD is increasingly common. This review mainly describes the interaction between HBV infection and NAFLD, the interaction between steatosis and antiviral drugs, and the prognosis of HBV infection complicated with NAFLD. Most studies suggest that HBV infection may reduce the incidence of NAFLD. NAFLD can promote the spontaneous clearance of hepatitis B surface antigen (HBsAg), but whether it affects antiviral efficacy has been reported inconsistently. HBV infection combined with NAFLD can promote the progression of liver fibrosis, especially in patients with severe steatosis. The outcome of HBV infection combined with NAFLD predisposing to the progression of HCC remains controversial.

Keywords: AVT, antiviral therapy; Antiviral efficacy; BMI, body mass index; CHB, chronic hepatitis B; CI, confidence interval; ETV, entecavir; HBV infection; HBV, hepatitis B virus; HBeAg, hepatitis B e antigen; HBsAg, hepatitis B surface antigen; HCC, hepatocellular carcinoma; HDL, high-density lipoprotein; HDL-C, high-density lipoprotein-cholesterol; HR, hazard ratio; HS, hepatis steatosis; Hepatocellular carcinoma; LDL-C, low-density lipoprotein cholesterol; Liver fibrosis; NA, nucleos(t)ide analogue; NAFLD, nonalcoholic fatty liver disease; NASH, nonalcoholic steatohepatitis; NR, not reported; Nonalcoholic fatty liver disease; OR, odds ratio; PEG-IFN, pegylated interferon; TAF, tenofovir alafenamide; TDF, tenofovir; TLR4, Toll-Like Receptor 4; aHR, adjusted hazard ratio; non-HDL-C, non-high-density lipoprotein-cholesterol.