Prevalence of steatosis and insulin resistance in patients with chronic hepatitis B compared with chronic hepatitis C and non-alcoholic fatty liver disease

Abstract The association of NAFLD with chronic hepatitis C (CHC) has been extensively studied but little is known about its coexistence with chronic hepatitis B (CHB). Aims To investigate the prevalence and determinants of steatosis and insulin resistance (IR) in CHB and its consequences on liver injury compared with CHC and NAFLD. Methods Patients with CHB (N = 110), CHC (N = 111) and NAFLD (N = 136) were evaluated by biomarkers of steatosis (SteatoTest > 0.38 as a surrogate for steatosis > 5%), IR (HOMA-IR > 2.7 as a surrogate for IR) and fibrosis (FibroTest > 0.48 as a surrogate for significant fibrosis, ≥ F2). Results HOMA-IR gradually increased in CHB, CHC and NAFLD: 2.3 ± 1.8; 3 ± 2.6 and 3.8 ± 2.7 (p   5% was 21% (CHB), 43% (CHC) and 82% (NAFLD), (p  In CHB, IR was related to host and not viral factors. CHB patients with steatosis had higher BMI (29 ± 5.7 kg/m 2 vs. 24 ± 4 kg/m 2 , p  Conclusions Steatosis may co-exist in CHB patients but with a lower prevalence than in CHC and NAFLD. In CHB steatosis is related to host and not viral factors, and is not associated with the severity of fibrosis.