Steatosis Has a Protective Effect and Is Not Associated With More Severe Disease in Hbeag Positive Chronic HBV With Raised Alanine Aminotransaminase

Introduction: The impact of steatosis on hepatitis B e antigen (HBeAg)-positive chronic hepatitis B virus (HBV) infection with raised serum alanine aminotransaminase (ALT) remains unknown. To determi Aim: ne the effect of steatosis in 112 treatment naive HBeAg-positive chronic HBV patients with raised serum ALT. Sixty-one of the 112 patient Methods: s (54.5%) had steatosis on liver biopsy (HBV plus Steatosis Group) while 51 of the 112 patients (45.5%) did not (HBV without Steatosis Group). Signicant chronic hepatitis was dened as having a modied histologic activity index 4-16. Results: Fibrosis stage was similar between the HBV plus Steatosis Group and HBV without Steatosis Group (mean 3.03 vs. 3.00; p=NS). Signicant chronic hepatitis was also similar between the HBV plus Steatosis Group and HBV without Steatosis Group [53/61 (86.9%) vs. 38/51 (74.5%), p=NS]. The HBV plus Steatosis Group had a lower intrahepatic hepatitis B surface antigen (HBsAg) when compared with the HBV without Steatosis Group (mean 0.49 vs. 1.00, respectively; p<0.001). Steatosis correlated negatively with intrahepatic HBsAg (r=-0.43, p<0.001). There was a trend that the HBV plus Steatosis group had a lower median serum HBV DNA level when compared with the HBV without Steatosis Group (6.73 vs. 7.62 Log IU/ml; p=0.07). In HBeAg positive chronic HBV infection wi Conclusion: th raised serum ALT levels, steatosis is not associated with an increased severity of liver disease. Steatosis with a lower intrahepatic HBsAg may offer protective effect against HBV.