The influence and prevalence of nonalcoholic steatohepatitis in chronic hepatitis B

Abstract The prevalence and the impact of nonalcoholic fatty liver disease (NAFLD) on chronic hepatitis B (CHB) are not well known. NAFLD as the hepatic manifestation of the metabolic syndrome (MS) is associated with obesity, diabetes mellitus and dislipidemia. To evaluate the prevalence and the impact of NAFLD on CHB. 120 patients diagnosed serologically and histological with CHB in 2006 in our center were retrospectively analyzed. Patients with self declared excessive alcohol consumption (above 20 g/day for males and 10 g/day for females) have been excluded. NAFLD was evaluated according to Brunt's score, while histology activity index (HAI) and fibrosis stage for CHB were estimated using Knodell score. The patients were divided in 2 groups: patients with CHB without steatosis (n = 61) and with steatosis (n = 59). Out of 120 patients with CHB (male/female = 76/44, median age = 40.41), 49.15% had steatosis. No statistically significant differences among fibrosis stages, HAI and the aminotransferase levels was found between the two groups (p = 0.320, p = 0.228, and p = 0.128). The presence of NAFLD associated with CHB was significantly correlated with age (p = 0.001) and MS (p = 0.051). In patients with CHB and steatosis, significant correlations between female sex and the presence of MS (p = 0.007) as between HAI and age (p = 0.003) were found. NAFLD was detected at 49.16% of patients with CHB. A positive correlation with age and MS (obesity, diabetes mellitus and/or dislipidemia) was observed. No significant correlations between NAFLD and the aminotransferase levels or histological features have been found.