ArticlePeerJ2026
Retrospective analysis of predictors for significant hepatic inflammation in metabolic-associated fatty liver disease with chronic hepatitis B.
Article in PeerJ, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The disease burden of metabolic dysfunction-associated fatty liver disease (MAFLD, non-alcoholic) combined with hepatitis B virus (HBV) infection is rising. Hepatic inflammation is a common pathway in liver disease progression, and evaluating its risk factors has clinical significance. In the context of concomitant MAFLD and HBV infection, hepatic inflammation may represent a key pathological pathway driving disease progression, making the assessment of liver inflammation crucial for controlling disease advancement. Objective: To identify independent risk factors for significant hepatic inflammation (grade ≥ 2) in patients with MAFLD (non-alcoholic) combined with HBV infection. Methods: This retrospective study included 447 treatment-naïve patients with metabolic dysfunction-associated fatty liver disease (non-alcoholic) and chronic hepatitis B who were diagnosed at Xiamen Hospital of Traditional Chinese Medicine between 2018 and 2024. Patients were stratified by body mass index (BMI) as normal weight (BMI < 25 kg/m Results: Baseline characteristics revealed statistically significant differences among BMI groups in controlled attenuation parameter (CAP), liver stiffness measurement (LSM), alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), uric acid (UA), glucose (GLU), hepatitis B surface antigen (HBsAg), hepatitis B e-antigen (HBeAg) positivity rate, and non-invasive indices APRI, GPR, and AAGP (all Conclusions: This clinical study was conducted based on histopathological findings and demonstrated that BMI, LSM, and HBV DNA are independent risk factors for the progression of hepatic inflammation in patients with MAFLD and HBV infection, whereas ALT served as an independent non-invasive predictor of this outcome. These findings provide a novel non-invasive approach for clinicians to assess the degree of hepatic inflammation when liver biopsy results are unavailable.
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