ArticleHepatology international2023
Distinct effects of hepatic steatosis and metabolic dysfunction on the risk of hepatocellular carcinoma in chronic hepatitis B.
Article in Hepatology international, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 4 of them syntheses that pooled it.
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Who cites it
49 citing papers in PubMed, 4 syntheses or guidelines pooled it, 55 citations in OpenAlex.
- APASL clinical practice guidelines on the management of chronic hepatitis B infection: a 2026 update.Hepatology international · 2026Guideline
- 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
- Metabolic (dysfunction)-associated fatty liver disease metrics and contributions to liver research.Hepatology international · 2024Pooled it
- Absence of steatosis combined with cardiometabolic risk factors confers the highest hepatocellular carcinoma risk in treated chronic hepatitis B.Annals of medicine · 2026Article
- Dynamic changes in controlled attenuation parameter (CAP) improve prognostic prediction for CHB patients with significant fibrosis and cirrhosis.Hepatology international · 2026Article
- 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
- [APASL clinical practice guidelines on the management of chronic hepatitis B infection: a 2026 update].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2026Article
- Steatosis paradox: Unraveling pathways of suppressive effect of hepatic steatosis on hepatitis B virus.Biomedical journal · 2026Review
- The Chronic Hepatitis B and Metabolic Dysfunction-Associated Steatotic Liver Disease Paradox: Friend or Foe?Gut and liver · 2026Review
- Observational
- Comparison of patients with HCC with and without MASLD after surgical resection.JHEP reports : innovation in hepatology · 2026Article
- Treatment strategies for patients with hepatitis B virus infection coexisting with hepatitis C virus or metabolic dysfunction-associated steatotic liver disease.Clinical and molecular hepatology · 2026Review
- Hepatocellular carcinoma risk stratification to identify patients suitable for intensive surveillance in viral hepatitis: the SELECT score.European radiology · 2026Article
- Reply to correspondence 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
- Diagnosis and management of metabolic dysfunction-associated steatohepatitis in patients with chronic hepatitis B infection.World journal of gastroenterology · 2026Review
- Spatial characterization of intrahepatic fat deposition across steatotic liver disease subcategories: a multicenter study.BMC medicine · 2026Article
- Prediction of Hepatocellular Carcinoma and Other Liver-Related Events in Chronic Hepatitis B Patients With Metabolic Dysfunction or Metabolic Dysfunction-Associated Steatotic Liver Disease.Alimentary pharmacology & therapeutics · 2026Article
- Review
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13 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveChronic hepatitis B (CHB) and metabolic dysfunction-associated fatty liver disease (MAFLD) are the leading causes of hepatocellular carcinoma (HCC). We aim to explore the impact of concurrent MAFLD on the risk of HCC in CHB.
methodsPatients with CHB were consecutively recruited from 2006 to 2021. MAFLD was defined by steatosis and either obesity, diabetes mellitus, or other metabolic abnormalities. The cumulative incidence of HCC and associated factors were compared between the MAFLD and non-MAFLD groups.
results10,546 treatment-naïve CHB patients were included with a median follow-up of 5.1 years. CHB patients with MAFLD (n = 2212) had fewer hepatitis B e antigen (HBeAg)-positivity, lower HBV DNA levels, and Fibrosis-4 index compared with the non-MAFLD group (n = 8334). MAFLD was independently associated with a 58% reduced risk of HCC (adjusted hazard ratio [aHR] 0.42, 95% confidence interval [CI] 0.25-0.68, p < 0.001). Furthermore, steatosis and metabolic dysfunction had distinct effects on HCC. Steatosis was protective against HCC (aHR 0.45, 95% CI 0.30-0.67, p < 0.001), while a greater burden of metabolic dysfunction increased the risk (aHR 1.40 per dysfunction increase, 95% CI 1.19-1.66, p < 0.001). The protective effect of MAFLD was further confirmed in analysis with inverse probability of treatment weighting (IPTW), patients who had undergone antiviral therapy, those with probable MAFLD, and after multiple imputation for missing data.
conclusionsConcurrent hepatic steatosis is independently associated with a lower risk of HCC, whereas the increasing burden of metabolic dysfunction aggravates the risk of HCC in untreated CHB patients.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.