Ergenc Ilkay, Gokcen Pinar, Adali Gupse, Tarik Kani Haluk, Ozer Demirtas Coskun, Gunduz Feyza, Ataizi Celikel Cigdem, Yilmaz Yusuf
Department of Gastroenterology, Marmara University School of Medicine, Istanbul, Turkey.
Department of Gastroenterology, University of Health Sciences Istanbul Umraniye Training and Research Hospital, Istanbul, Turkey.
Hepatol Forum. 2021 Jan 8;2(1):20-25. doi: 10.14744/hf.2020.2020.0025. eCollection 2021 Jan.
The coexistence of metabolic-associated fatty liver disease (MAFLD) in the course of chronic hepatitis B virus infection increases liver-related morbidity. A positive correlation was found between positive hepatitis B core antibody (anti-HBc) and the risk of cirrhosis and hepatocellular carcinoma (HCC) in MAFLD. The relationship between anti-HBc positivity and MAFLD progression to fibrosis, cirrhosis, and liver-related outcomes was determined.
This is a retrospective study including 242 patients with biopsy-proven MAFLD, 130 patients with clinically diagnosed MAFLD-related cirrhosis, and 62 patients with MAFLD-related or cryptogenic HCC. Anti-HBc antibody results were compared with clinical outcomes.
Anti-HBc positivity was associated with fibrosis severity (p=0.005). Anti-HBc was positive in 19 (20.2%), 33 (25.8%), 53 (35.3%), and 27 (43.5%) patients with F0-F1 fibrosis, F2-F3 fibrosis, cirrhosis (F4), and HCC, respectively. Median steatosis score was grade 3 in anti-HBc positive patients and grade 2 in negative patients (p=0.07). Anti-HBc positivity was not associated with significant fibrosis (≥F2), cirrhosis, and any liver related complications including HCC.
Higher anti-HBc positivity was found in MAFLD patients with advanced fibrosis and cirrhosis compared to patients with early stage fibrosis. No relation was found between anti-HBc positivity and development of cirrhosis, HCC or other liver related complications.
慢性乙型肝炎病毒感染过程中代谢相关脂肪性肝病（MAFLD）的共存会增加肝脏相关发病率。在MAFLD中，乙型肝炎核心抗体（抗-HBc）阳性与肝硬化及肝细胞癌（HCC）风险之间存在正相关。本研究确定了抗-HBc阳性与MAFLD进展为纤维化、肝硬化及肝脏相关结局之间的关系。
这是一项回顾性研究，纳入242例经活检证实的MAFLD患者、130例临床诊断为MAFLD相关肝硬化的患者以及62例MAFLD相关或隐源性HCC患者。将抗-HBc抗体结果与临床结局进行比较。
抗-HBc阳性与纤维化严重程度相关（p=0.005）。在F0-F1纤维化、F2-F3纤维化、肝硬化（F4）和HCC患者中，抗-HBc阳性的患者分别有19例（20.2%）、33例（25.8%）、53例（35.3%）和27例（43.5%）。抗-HBc阳性患者的中位脂肪变性评分为3级，阴性患者为2级（p=0.07）。抗-HBc阳性与显著纤维化（≥F2）、肝硬化以及包括HCC在内的任何肝脏相关并发症均无关联。
与早期纤维化患者相比，晚期纤维化和肝硬化的MAFLD患者抗-HBc阳性率更高。未发现抗-HBc阳性与肝硬化、HCC或其他肝脏相关并发症的发生之间存在关联。
