Metabolic comorbidities exacerbate risk for liver-related events in chronic HBV
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Key takeaways:
- Metabolic comorbidities increased the risk for liver-related events among patients with chronic hepatitis B virus.
- Patients with two or more comorbidities were at the highest risk for liver-related events.
Metabolic comorbidities heightened risk for adverse liver-related events among patients with chronic hepatitis B virus, with the highest risk found among patients with multiple comorbidities, according to research.
“The leading causes of death among patients with chronic HBV (CHB) are hepatocellular carcinoma and liver cirrhosis-related complications,” Lesley A. Patmore, MD, from the department of gastroenterology and hepatology at Erasmus MC University Medical Center in The Netherlands, and colleagues wrote in Clinical Gastroenterology and Hepatology. “Although antiviral treatment is now widely available and can effectively suppress serum HBV DNA levels, antiviral therapy reduces but not eliminates the risk of adverse clinical outcomes.”
Patmore and colleagues added: “This may partially be explained by the rapid increase in the prevalence of the metabolic syndrome comprising overweight, diabetes mellitus, hypertension, dyslipidemia, in patients with CHB.”
In a retrospective cohort study, researchers aimed to investigate the association between metabolic comorbidities and liver-related outcomes among 1,850 patients (median age 37 years, 61.1% men) with chronic HBV. Overall, 55.4% of patients in this cohort had one or more comorbidities: 50.1% were overweight, 10.1% had cirrhosis, 8.7% had hypertension, 6.3% had dyslipidemia and 4.4% had diabetes.
During a median follow-up of 7.3 years, Patmore and colleagues recorded 111 first events comprising of HCC incidence among 3.8%, liver transplantation among 2.3% and liver-related mortality among 2.3%. The 5- and 10-year cumulative incidence of liver-related events was 4% (95% CI, 1-5) and 6.9% (95% CI, 5.5-8.3), respectively.
Additionally, results showed presence of hypertension (HR = 8.3; 95% CI, 5.5-12.7), diabetes (HR = 5.4; 95% CI, 3.2-9.1), dyslipidemia (HR = 2.8; 95% CI, 1.6-4.8) and overweight (HR = 1.7; 95% CI, 1.1-2.5) was “significantly associated” with an increased risk for liver-related events with 5-year and 10-year cumulative incidence increasing in the presence of 2 or more comorbidities (4.2% and 8.2% vs. 14.8% and 21.8%). Researchers noted consistent findings among both patients with and without cirrhosis.
“Presence of metabolic comorbidities is associated with an increased risk of liver-related events in patients with CHB, with the highest risk observed in patients with multiple comorbidities,” Patmore and colleagues wrote. “Findings were consistent for patients with and without cirrhosis at study entry, across age-male-ALBI-platelet risk categories and among non-cirrhotic HBV surface antigen-negative patients with low viral load. Our findings support the need for thorough metabolic assessment in patients with CHB.”
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