Systematic review with meta‐analysis: prevalence of hepatic steatosis, fibrosis and associated factors in chronic hepatitis B

• Published in: Alimentary pharmacology & therapeutics Vol. 54; no. 9; pp. 1100 - 1109
• Main Authors: Zheng, Qi, Zou, Biyao, Wu, Yuankai, Yeo, Yeehui, Wu, Huizhen, Stave, Christopher D, Cheung, Ramsey C., Nguyen, Mindie H.
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01-11-2021
• Subjects: Adult; Aged; Deoxyribonucleic acid; Diabetes mellitus; DNA; Fatty Liver; Fibrosis; Hepatitis B; Hepatitis B e antigen; Hepatitis B e Antigens; Hepatitis B, Chronic - complications; Hepatitis B, Chronic - epidemiology; Humans; Interferon; Male; Meta-analysis; Metabolism; Prevalence; Steatosis
• DOI: 10.1111/apt.16595
• EISSN: 1365-2036
• ISSN: 0269-2813

Summary
Background
As the prevalence of hepatitis steatosis (HS) increases, the prevalence of HS among those with chronic hepatitis B (CHB) may also be increasing but data on the effect of HS on CHB disease progression are lacking.
Aims
To determine the prevalence of HS in CHB and associated factors, prevalence of fibrosis and its association with HS.
Methods
Two researchers independently searched the literature and extracted data. We included full‐length original articles of adults with CHB that evaluated. Prevalence estimates were pooled using a random‐effects model. Associations between HS and fibrosis were assessed by pooled odds ratios (ORs) or mean differences (MD).
Results
Of the 2821 records screened, 54 eligible studies (28 648 patients) were analysed. The pooled prevalence of HS in CHB was 32.8% (95% CI, 28.9‐37.0) with higher prevalence in men and obese patients. Older age, male sex and metabolic factors were associated with HS while an inverse association was observed between HS and HBeAg (OR 0.82, 95% CI, 0.75‐0.91) and HBV DNA levels (MD −0.38, 95% CI −1.16‐−0.42). The pooled prevalence of significant fibrosis (≥F2 or ≥F3) was similar between patients with CHB with or without HS (40.1% vs 42.22%, P = 0.68). HS was not significantly associated with fibrosis (pooled OR 0.87, 95% CI 0.54‐1.39, 20 studies, 6232 patients).
Conclusions
Approximately 30% of patients with CHB had HS, which was positively associated with male sex, diabetes and metabolic factors, and was negatively associated with HBeAg and HBV DNA. HS was not significantly associated with increased fibrosis.
The pooled prevalence of HS in CHB was 32.83%, which was positively associated with male sex, diabetes, metabolic factors, and negatively associated with HBeAg and HBV DNA. HS was not significantly associated with increased fibrosis.