Abstract

The pathogenesis involving non-alcoholic fatty liver disease (NAFLD) in the context of chronic HBV (CHB) virus infection requires to be understood for developing improved modalities of diagnosis and treatment. We retrospectively investigated the association between NAFLD and CHB virus infection in the context of liver fibrosis. Among the 522 consecutive CHB patients who underwent transient elastography between years 2013 and 2016, we studied 455 subjects in the current investigation. Controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) scores were generally higher in patients with steatosis and fibrosis or cirrhosis. Antiviral treatment had significantly reduced the hepatitis B virus (HBV) viral load. Other liver function markers showed a significant positive correlation with both CAP and LSM scores. Plasma IL-13 was independently associated with increased CAP score where every increase of 1 unit of IL-13 was associated with an increase in CAP score by 0.98 unit. CCL11 was independently associated with LSM with every increase of CCL11 by a unit that, in turn, was associated with an increase of LSM score. We found that there was a high concurrence of NAFLD among patients with CHB virus infection. The presence of metabolic syndrome and chronic inflammation in CHB virus-infected patients were two independent factors that led to the progression of liver cirrhosis, with IL-13 playing the key role in linking the metabolic with the inflammatory components.

摘要

需要了解慢性 HBV (CHB) 病毒感染中非酒精性脂肪性肝病 (NAFLD) 的发病机制，以开发改进的诊断和治疗方式。我们回顾性研究了肝纤维化背景下 NAFLD 与 CHB 病毒感染之间的关联。在 2013 年至 2016 年间接受瞬时弹性成像的 522 名连续 CHB 患者中，我们在当前调查中研究了 455 名受试者。脂肪变性和纤维化或肝硬化患者的受控衰减参数 (CAP) 和肝脏硬度测量 (LSM) 评分通常较高。抗病毒治疗显着降低了乙型肝炎病毒 (HBV) 病毒载量。其他肝功能指标与 CAP 和 LSM 评分均呈显着正相关。血浆 IL-13 与 CAP 评分增加独立相关，其中每增加 1 个单位的 IL-13 与 CAP 评分增加 0.98 个单位相关。CCL11 与 LSM 独立相关，CCL11 每增加一个单位，又与 LSM 分数的增加相关。我们发现在 CHB 病毒感染患者中 NAFLD 的并发率很高。CHB 病毒感染患者中代谢综合征和慢性炎症的存在是导致肝硬化进展的两个独立因素，IL-13 在将代谢与炎症成分联系起来方面起着关键作用。CCL11 与 LSM 独立相关，CCL11 每增加一个单位，又与 LSM 分数的增加相关。我们发现在 CHB 病毒感染患者中 NAFLD 的并发率很高。CHB 病毒感染患者中代谢综合征和慢性炎症的存在是导致肝硬化进展的两个独立因素，IL-13 在将代谢与炎症成分联系起来方面起着关键作用。CCL11 与 LSM 独立相关，CCL11 每增加一个单位，又与 LSM 分数的增加相关。我们发现在 CHB 病毒感染患者中 NAFLD 的并发率很高。CHB 病毒感染患者中代谢综合征和慢性炎症的存在是导致肝硬化进展的两个独立因素，IL-13 在将代谢与炎症成分联系起来方面起着关键作用。