PATIENTS with chronic hepatitis B who have two or more metabolic comorbidities may be at higher risk for adverse liver-related events, according to a new study. While antiviral treatment is now available to suppress serum chronic hepatitis B virus DNA levels, the risk of adverse clinical outcomes it not eliminated in patients with chronic hepatitis B. Lesley Patmore, Erasmus MC University Medical Center, the Netherlands, and colleagues, stated: “This may partially be explained by the rapid increase in the prevalence of the metabolic syndrome comprising overweight, diabetes mellitus, hypertension, dyslipidaemia, in patients with chronic hepatitis B.”
Patmore and colleagues conducted a retrospective cohort study, aiming to identify associations between metabolic comorbidities and liver-related outcomes. The cohort included 1,850 patients (median age: 37 years; 61.1% male) with chronic hepatitis B virus. Of these patients, 55.4% had one or more comorbidities: 10.1% had cirrhosis, 50.1% were overweight, 6.3% had dyslipidaemia, 8.7% had hypertension, and 4.4% with diabetes.
The mean follow-up was 7.3 years, during which 111 first events were recorded, including hepatocellular cancer in 3.8%, liver-related mortality in 2.3%, and liver transplantation among 2.3%. The team noted a 5- and 10-year cumulative incidence of liver-related events of 4.0% and 6.9%, respectively. Furthermore, the presence of diabetes, dyslipidaemia, overweight, and hypertension was significantly associated to an increased risk of liver-related events, leading to an increase in 5- and 10-year cumulative incidence when two or more comorbidities were present.
The team concluded that metabolic comorbidities are associated with a higher risk of liver-related events in patients with chronic hepatitis B and that this risk is increased in those with multiple comorbidities. The team wrote: “Findings were consistent for patients with and without cirrhosis at study entry, across age-male-ALBI [albumin-bilirubin]-platelet risk categories and among non-cirrhotic hepatitis B virus surface antigen-negative patients with low viral load.” These findings confirm that thorough metabolic assessment in patients with chronic hepatitis B is necessary.
