ArticleHepatology international2021
Reduced hepatic steatosis is associated with higher risk of hepatocellular carcinoma in chronic hepatitis B infection.
Article in Hepatology international, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 4 of them syntheses that pooled it.
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Who cites it
38 citing papers in PubMed, 4 syntheses or guidelines pooled it, 53 citations in OpenAlex.
- Prevalence and clinical characteristics of concurrent chronic hepatitis B and fatty liver disease in China: a systematic review and meta-analysis.BMC public health · 2025Pooled it
- The Asian Pacific association for the study of the liver clinical practice guidelines for the diagnosis and management of metabolic dysfunction-associated fatty liver disease.Hepatology international · 2025Guideline
- Low liver fat in non-alcoholic steatohepatitis-related significant fibrosis and cirrhosis is associated with hepatocellular carcinoma, decompensation and mortality.Alimentary pharmacology & therapeutics · 2024Pooled it
- Impact of fatty liver on long-term outcomes in chronic hepatitis B: a systematic review and matched analysis of individual patient data meta-analysis.Clinical and molecular hepatology · 2023Pooled it
- Dynamic changes in controlled attenuation parameter (CAP) improve prognostic prediction for CHB patients with significant fibrosis and cirrhosis.Hepatology international · 2026Article
- Article
- Chronic viral hepatitis with concurrent metabolic dysfunction-associated steatotic liver disease: dual etiology challenges.Clinical and molecular hepatology · 2026Review
- Droplet Digital PCR Measurement of HBV DNA in On-Treatment Chronic HBV Patients: Association With HCC Development and Outcomes.Journal of viral hepatitis · 2026Article
- Steatosis paradox: Unraveling pathways of suppressive effect of hepatic steatosis on hepatitis B virus.Biomedical journal · 2026Review
- Etiology-Based Treatment for Unresectable/Advanced Hepatocellular Carcinoma: Focus on Viral Hepatitis and Metabolic Dysfunction-Associated Steatohepatitis.Liver cancer · 2026Review
- The Chronic Hepatitis B and Metabolic Dysfunction-Associated Steatotic Liver Disease Paradox: Friend or Foe?Gut and liver · 2026Review
- Hepatocellular carcinoma risk stratification to identify patients suitable for intensive surveillance in viral hepatitis: the SELECT score.European radiology · 2026Article
- Impact of Metabolic Associated Steatotic Liver Disease on Antiviral Therapy Outcomes on Chronic Hepatitis B Patients Receiving Antiviral Therapy.Journal of medical virology · 2026Article
- Association between fatty liver and risk of liver failure in patients with acute hepatitis B: a retrospective cohort study.Frontiers in cellular and infection microbiology · 2026Article
- Metabolic health in antiviral era of chronic hepatitis B: Editorial on "Impacts of metabolic syndrome diseases on long-term outcomes of chronic hepatitis B patients treated with nucleos(t)ide analogues".Clinical and molecular hepatology · 2026Article
- [Research progress on the impact of metabolic associated fatty liver disease on viral activity, treatment response, and prognosis in patients with chronic hepatitis B: current status and prospects].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2025Review
- Diagnostic performance of attenuation imaging versus controlled attenuation parameter for hepatic steatosis with MRI-based proton density fat fraction as the reference standard: a prospective multicenter study.Journal of gastroenterology · 2025Article
- Mechanisms of hepatocellular carcinoma and cirrhosis development in concurrent steatotic liver disease and chronic hepatitis B.Clinical and molecular hepatology · 2025Review
- Studying the Effect of Hepatic Steatosis on Liver Stiffness Measurement (LSM) in HBV Patients With and Without Therapy.International journal of hepatology · 2025Article
- Unveiling Prevalence, Risk Factors, and Outcomes of Hepatitis D Among Vulnerable Communities in Romania.Viruses · 2024Article
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundConcomitant chronic hepatitis B infection (CHB) and non-alcoholic fatty liver disease (NAFLD) is common, but the implications of NAFLD on clinical outcomes of CHB, including hepatocellular carcinoma (HCC), are not well-investigated.
methodsCHB patients were recruited for transient elastography assessment for liver stiffness (LS), and controlled attenuation parameter (CAP), a non-invasive quantification of hepatic steatosis, and were prospectively followed up for development of HCC. Steatosis and severe steatosis were diagnosed by CAP ≥ 248 dB/m and ≥ 280 dB/m respectively, and advanced fibrosis/cirrhosis was diagnosed by LS ≥ 9 kPa. The independent effect of hepatic steatosis on HCC was examined via propensity score matching (PSM) of LS and other significant clinical variables.
resultsForty-eight patients developed HCC among 2403 CHB patients (55.6% male, median age 55.6 years, 57.1% antiviral-treated, median ALT 26 U/L) during a median follow-up of 46.4 months. Multivariate Cox regression analysis showed age (HR 1.063), male (HR 2.032), Albumin-Bilirubin score (HR 2.393) and CAP (HR 0.993) were associated with HCC development. The cumulative probability of HCC was 2.88%, 1.56% and 0.71%, respectively for patients with no steatosis, mild-to-moderate steatosis, and severe steatosis, respectively (p = 0.01). The risk of HCC increased from 1.56 to 8.89% in patients without severe steatosis if advanced fibrosis/cirrhosis was present (p < 0.001). PSM yielded 957 pairs of CHB patients and hepatic steatosis was independently associated with HCC (HR 0.41).
conclusionReduced hepatic steatosis was significantly associated with a higher risk of incident HCC in CHB infection. Routine CAP and LS measurements are important for risk stratification.
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