Hepatitis B virus infection and fatty liver in the general population

• Published in: Journal of hepatology Vol. 56; no. 3; pp. 533 - 540
• Main Authors: Wong, Vincent Wai-Sun, Wong, Grace Lai-Hung, Chu, Winnie Chiu-Wing, Chim, Angel Mei-Ling, Ong, Arlinking, Yeung, David Ka-Wai, Yiu, Karen Kar-Lum, Chu, Shirley Ho-Ting, Chan, Hoi-Yun, Woo, Jean, Chan, Francis Ka-Leung, Chan, Henry Lik-Yuen
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier B.V 01.03.2012; Elsevier
• Subjects: Adolescent; Adult; Aged; Biological and medical sciences; Cross-Sectional Studies; Cross-sectional study; Diabetes mellitus; Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - metabolism; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Fatty Liver - ethnology; Fatty Liver - metabolism; Female; Gastroenterology and Hepatology; Gastroenterology. Liver. Pancreas. Abdomen; Hepatitis B, Chronic - epidemiology; Hepatitis B, Chronic - metabolism; Hong Kong - epidemiology; Human viral diseases; Humans; Hypertriglyceridemia; Hypertriglyceridemia - epidemiology; Hypertriglyceridemia - metabolism; Infectious diseases; Lipid Metabolism - physiology; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Medical sciences; Metabolic Syndrome - epidemiology; Metabolic Syndrome - metabolism; Middle Aged; Nonalcoholic fatty liver disease; Nonalcoholic steatohepatitis; Obesity; Other diseases. Semiology; Prevalence; Risk Factors; Viral diseases; Viral hepatitis; Young Adult; Obesity; NAFLD; CI; Diabetes mellitus; HBeAg; Anti-HBe; 1H-MRS; Nonalcoholic steatohepatitis; Hypertriglyceridemia; Nonalcoholic fatty liver disease; Cross-sectional study; HBV; HBx; hepatitis B X; hepatitis B virus; proton-magnetic resonance spectroscopy; antibody against hepatitis B e antigen; hepatitis B e antigen; nonalcoholic fatty liver disease; confidence interval; Endocrinopathy; Metabolic diseases; Hepatic disease; Lipids; Hyperlipoproteinemia; Lipoprotein; Triglyceride; Enzymopathy; Infection; Viral hepatitis B; Obes ity; Fatty liver; Viral disease; Cross sectional study; Non alcoholic steatohepatitis; Gastroenterology; Digestive diseases; Dyslipemia
• ISSN: 0168-8278; 1600-0641; 1600-0641
• DOI: 10.1016/j.jhep.2011.09.013

In animal studies, expression of hepatitis B virus (HBV) proteins causes hepatic steatosis. We aimed to study the prevalence of fatty liver in people with and without HBV infection in the general population. We performed a cross-sectional population study in Hong Kong Chinese. Intrahepatic triglyceride content (IHTG) was measured by proton-magnetic resonance spectroscopy. One thousand and thirteen subjects (91 HBV patients and 922 controls) were recruited. The median IHTG was 1.3% (0.2–33.3) in HBV patients and 2.1% (0–44.2) in controls (p <0.001). Excluding subjects with significant alcohol consumption, the prevalence of nonalcoholic fatty liver disease was 13.5% (95% confidence interval [CI] 6.4%, 20.6%) in HBV patients and 28.3% (95% CI 25.3%, 31.2%) in controls (p=0.003). The fatty liver prevalence differed in HBV patients and controls aged 40–59years but was similar in those aged 60years or above. After adjusting for demographic and metabolic factors, HBV infection remained an independent factor associated with lower risk of fatty liver (adjusted odds ratio 0.42; 95% CI 0.20, 0.88; p=0.022). HBV patients also had a lower prevalence of metabolic syndrome (11.0% vs. 20.2%; p=0.034), but the difference was mainly attributed to lower triglyceride levels. Among HBV patients, viral genotypes, HBV DNA level and hepatitis B e antigen status were not associated with fatty liver. HBV infection is associated with a lower prevalence of fatty liver, hypertriglyceridemia and metabolic syndrome. Viral replication may affect lipid metabolism and this warrants further studies.