ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2019) 63 P883 | DOI: 10.1530/endoabs.63.P883

Impact of the overweight and fatty liver in chronic hepatitis B treatment

Roua Kallel, Imen Akkari, Soumaya Mrabet, Imen Jemni & Elhem Ben Jezia

Hepatogastrology Department, Farhat Hached Hospital, Sousse, Tunisia.

Background: More than 1.9 billion people in the world are suffering from overweight. Damages can be caused to the liver such as fatty liver or even Cirrhosis. The aims of this study are to determine the prevalence and the impact of steatosis and overweight on therapeutic response in chronic hepatitis B.

Methods: This is a descriptive transversal study enrolled from 01/2010 to 09/2018. All patients with chronic hepatitis B investigated by liver biopsy were included. Alcoholic consumption and hepatitis C were the exclusion criteria. Data were collected and analyzed with SPSS (significant P< 0.05).

Results: 76 patients were included in the study. The average age of patients was 36-year-old with a sex ratio (M/F)=1.92. Four patients were diabetic. The average body mass index (BMI) was 26 kg / m2. 58% were in overweight and 17% were obese. According to the Metavir score, hepatitis activity was graded: A0 (14.5%); A1 (60.5%); A2 (22.4%); A3 (2.6%) and fibrosis: F0 (10.5%); F1 (44.7%); F2 (40.8%); F3 (4%). Steatosis was present in liver biopsy in 26 patients (34%). 54% patients were treated, 61% by Pegylated interferon and 49% by Entecavir. A sustained virological response was obtained in (54%) of cases, a non-primary response (39%) and a relapse (7%). A second-line treatment was prescribed with a sustained virological response in 100% of cases. There was a significant difference in BMI (28.32 vs 24.83, P<0.005) and hyperechoic liver (39% vs 10%, P=0.005 and OR=5.6, (1.6-18.9)). It was not the case for age, cytolysis, HBeAg status, and virological activity. The presence of steatosis was not correlated with the severity of fibrosis (P=0.43). Steatosis did not influence the response to antiviral therapy (23% vs. 5%, P=0.08). Even overweight (41% vs 57%, p0.09) and obesity (50% vs 50%, P=0.61) did not influence the response to treatment.

Conclusion: Although the young age of patients, the absence of diabetes the prevalence of non-alcoholic fatty liver was high. The role of hepatitis B infection may be suggested. Only the overweight or hyperechoic liver were predictive of the coexistence of steatosis. Overweight, obesity and steatosis does not influence fibrosis progression or therapeutic response.

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