Therapeutic effect of antiviral therapy in chronic hepatitis B patients with nonalcoholic fatty liver disease

ObjectiveTo retrospectively analyze the therapeutic effect of antiviral therapy in the chronic hepatitis B (CHB) patients with nonalcoholic fatty liver disease (NAFLD) and to investigate whether hepatocyte steatosis affects the response to antiviral therapy in CHB patients. MethodsA total of 110 CHB patients and 99 CHB patients with NAFLD were enrolled in the study. Serum HBV DNA levels were measured by fluorescence quantitative PCR; serum HBsAg, HBsAb, HBeAg, HBeAb, and HBcAb were quantified by chemiluminescence; biochemical indices were determined by automatic biochemical analyzer to evaluate the liver function. Results(1) When receiving antiviral therapy with interferon, the CHB patients had a significantly higher rate of alanine aminotransferase (ALT)/aspartate aminotransferase (AST) normalization after 24 weeks of treatment (χ2=4.069, P=0.044) and a significantly higher rate of HBV DNA clearance after 48 weeks of treatment (χ2=17.327, P=0.000), as compared with the CHB patients with NAFLD; in all HBeAg-positive patients, those with only CHB had a significantly higher rate of ALT/AST normalization after 24 weeks of treatment (P＜0.05) and significantly higher rates of HBV DNA clearance and HBeAg clearance after 24 and 48 weeks of treatment (P＜0.05), as compared with those with CHB and NAFLD, but there was no significant difference in the rate of ALT/AST normalization between them after 48 weeks of treatment (P＞0.05). (2) When receiving antiviral therapy with nucleos(t)ide analogues, the CHB patients had a significantly higher rate of ALT/AST normalization than the CHB patients with NAFLD after 48 weeks of treatment (χ2=7.620, P=0.006), but there was no significant difference in the rate of HBV DNA clearance between them after 24 and 48 weeks of treatment (P＞0.05); in all HBeAg-positive patients, those with CHB and NAFLD had a significantly higher rate of HBeAg clearance after 24 weeks of treatment (P＜0.05) and a significantly lower rate of ALT/AST normalization after 48 weeks of treatment (P＜0.05), as compared with those with only CHB, but there were no significant differences in the rate of ALT/AST normalization after 24 weeks of treatment, rates of HBV DNA clearance after 24 and 48 weeks of treatment, and rate of HBeAg clearance after 48 weeks of treatment between them (P＞0.05). ConclusionTo some extent, hepatocyte steatosis affects the response to antiviral therapy in CHB patients.