Chronic HBV ‘positively associates’ with severe necroinflammation in pediatric MASLD
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Key takeaways:
- Analysis demonstrated an inverse association between the degree of hepatic steatosis and grade of necroinflammation.
- Platelet count and total cholesterol were positively associated with severity of steatosis.
Chronic hepatitis B virus infection was positively linked with severe hepatic necroinflammation in children with metabolic dysfunction-associated steatotic liver disease but did not appear to affect hepatic fibrosis, according to data.
“Both NAFLD and chronic hepatitis B infection (CBI) are conditions generally associated with hepatic necroinflammation, hepatic fibrosis, cirrhosis and liver cancer,” Lu Wang, from Peking University International Hospital, and colleagues wrote in BMC Gastroenterology. “Emerging epidemiological evidence has demonstrated that CBI is inversely associated with hepatic steatosis.”
They continued: “A higher frequency of poor outcomes in pediatric NAFLD has been observed in comparison to adult population. Thus, it is worth exploring if NAFLD with overlapping CBI could accelerate or suspend the progression of liver disease in NAFLD population, especially in pediatric patients.”
In a retrospective study, researchers included 223 children with biopsy-proven MASLD, formerly known as nonalcoholic fatty liver disease, of whom 161 did not have concurrent chronic HBV and 62 did.
Researchers reported mild hepatic steatosis among 7.5% in the group without chronic HBV and 73.2% in the co-infected group, moderate steatosis among 24.8% and 17.7%, respectively, and severe steatosis among 67.7% and 8.1%.
When grouped by grade of hepatic steatosis, adjusted multivariate analysis demonstrated an inverse association between the degree of hepatis steatosis (OR = 0.037; 95% CI, 0.014-0.098) and the grade of hepatic necroinflammation. Conversely, platelet (OR = 1.008; 95% CI, 1.003-1.014) and total cholesterol (OR = 2.479; 95% CI, 1.082-5.678) were positively associated with severity of hepatic steatosis.
Further, results showed children with MASLD and “significant fibrosis” presented with more severe hepatic necroinflammation compared with those who had no or mild fibrosis (61.4% vs. 24.8%). Chronic HBV also was independently associated with severity of hepatic necroinflammation in children with MASLD (OR = 6.125; 95% CI, 1.958-19.158).
“CBI is inverse associated with the grade of steatosis and positively associates with severe hepatic necroinflammation in NAFLD children,” Wang and colleagues concluded. “However, CBI does not appear to affect significant hepatic fibrosis in NAFLD pediatric population.”
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