Impact of fatty liver on antiviral effect in chronic hepatitis B / 重庆医学

ABSTRACT

Objective To investigate the impact of fatty liver on antiviral effect in the patients with chronic hepatitis B (CHB) .Methods A total of 204 patients with hepatitis Be antigen (HBeAg ) positive CHB in the outpatient department of our hospital from January 2011 to April 2014 were selected as the research subjects and divided into the two groups according to wheth‐er complicating fatty liverthe simple CHB group(control group ,122 cases) and CHB complicating nonalcoholic fatty liver disease (NAFID) group(observation group ,82 cases) .The two groups all received the 24‐week antiviral therapy of adefovir (10 mg/d) . The differences in the normalization rate of ALT/AST (biochemical response) ,HBeAg negative conversion rate (serological re‐sponse) and HBV DNA negative conversion rate(virological response) were compared between the two groups .Then the cases ob‐taining the virological response after treatment in the two groups were compared again .Among the cases obtaining virological re‐sponse,thedifferencesinthenormalizationrateofALT/AST(biochemicalresponse)andHBeAgnegativeconversionrate(serologi‐cal response) were compared between the simple CHB group and CHB complicating NAFID group .Results The normalization rate of ALT/AST after 24‐week treatment in the CHB complicating NAFID group was 58 .5% ,which was significantly lower than 72 .1% in the simple CHB group ,the difference was statistically significant ;the negative conversion rate of HBV DNA and HBeAg after 24‐week treatment in the simple CHB group was 67 .2% and 52 .5% ,which were significantly higher than 51 .2% and 37 .8%respectively ,the differences were statistically significant ;among the cases obtaining the virological response ,the normalization rate of ALT/AST in the simple CHB group was 96 .3% ,which was significantly higher than 66 .7% in the CHB complicating NAFID group ,the difference was statistically significant .But among the cases obtaining the virological response ,the negative conversion rate of HBeAg was 78 .0% in the simple CHB group and 73 .8% in the CHB complicating NAFID group ,the simple CHB group was slightly higher than the CHB complicating NAFID group without statistical difference .Conclusion NAFLD has impact on the antiviral effect of adefovir treatment in CHB patients with positive HBeAg ,whereas complicating NAFLD is an important reason for reaching the virological response and serological response ,but without reaching the biochemical response in the antiviral treatment of CHB complicating NAFID .