Clinical features of chronic HBV/HCV infection complicated by mild hepatic steatosis / 临床肝胆病杂志

ABSTRACT

ObjectiveTo investigate the clinical features of previously untreated patients with chronic HBV/HCV infection complicated by mild hepatic steatosis. MethodsA total of 111 previously untreated patients with chronic HBV/HCV infection who were hospitalized in Zhengzhou University People's Hospital from December 2014 to January 2016. Liver biopsy confirmed that all the patients had mild hepatic steatosis. Among these patients, 65 had HBV infection and 46 had HCV infection. The changes in clinical indices such as liver function, blood lipid, blood glucose, and liver stiffness measurement (LSM) were compared between the two groups. The independent samples t-test or Wilcoxon two-sample test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. ResultsThere were significant differences in LSM, aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), plasma albumin (Alb), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and platelet count (PLT) between the two groups (all P＜0.05). According to liver inflammation grade and fibrosis stage, the patients were divided into G＜2/S＜2 group (0, 0-1, 1, 1-2) and G≥2/S≥2 group (2, 2-3, 3-4, 4). LSM showed significant differences across the groups with different liver inflammation grades and fibrosis stages (HBV infection：640(530~770)vs 830(590~1130),Z=-2463,P=0014；670(530~780)vs 830(570~1130),Z=-2049,P=0040。HCV infection：760(630~1150)vs 1750(1200~2670),Z=-3961,P＜0001；760（590~1020）vs 1550(750~2150),Z=-3325,P=0001). In the patients with chronic HCV infection, TC showed a significant difference between the groups with different fibrosis stages (428±085 vs 382±068，t=2.045, P=0.047). ConclusionCompared with the previously untreated patients with chronic HBV infection complicated by mild hepatic steatosis, those with HCV infection complicated by mild hepatic steatosis have higher LSM, GGT, TC, and LDL-C, as well as lower Alb, PLT, AST, and HDL-C. In addition, the parameters associated with hepatic steatosis (BMI, GLU, fat attenuation parameter, blood lipid) are not positively correlated with disease progression.