Background and aim: Steatosis and insulin resistance (IR) are the majordisease modifying in patients with chronic hepatitis C (CHC). Only fewstudies evaluated these features in patients with chronic hepatitis B (CHB).We aimed to assess the prevalence and the characteristics of steatosis and IRin CHB patients, compared to CHC subjects, and to evaluate the potentialassociation between these features and fibrosis severity.Material and methods: 170 consecutive patients with CHB (28 HBeAgpositive, 128 HBeAg negative, and 14 HBeAg negative/anti-HDV positive),and 170 sex, age and BMI matched genotype 1 CHC patients were evaluatedby liver biopsy and metabolic measurements, including IR, by the homeostasismodel assessment (HOMA). Insulin resistance was defined if HOMA-IR>2.7.All biopsies were scored by one pathologist for staging and grading (Scheuer).Steatosis was considered significant if ≥10%.Results: The prevalence of significant steatosis was similar in both CHB andCHC patients (31% vs. 38%; p=0.14). IR rate was significantly higher in CHCthan in CHB patients (42% vs. 26%; p=0.002). In CHB patients, at multivariateanalysis, severe fibrosis (F3-F4) was independently associated witholder age (OR 1.054,95%CI 1.007–1.103, p=0.02), low platelet levels (OR0.984,95%CI 0.973–0.994, p=0.003), high GGT (OR 1.019,95%CI 1.001–1.039, p=0.04), steatosis>10% (OR 3.601,95%CI 1.272–10.194, p=0.01), andmoderate-severe necroinflammatory activity (OR 8.111,95%CI 1.884–34.925,p=0.005), regardless HBeAg status and HDV co-infection.Conclusions: CHB patients had high steatosis prevalence, similar to CHCcontrols, but lower IR rate. Steatosis, is independently associated with severefibrosis in CHB patients.
|Numero di pagine||1|
|Stato di pubblicazione||Published - 2010|