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Goossens N1, de Vito C2, Mangia A3, Clément S2, Cenderello G4, Barrera F5, D'Ambrosio R6, Coppola N7, Zampino R8, Stanzione M9, Adinolfi LE8, Wedemeyer H10, Semmo N11, Müllhaupt B12, Semela D13, Malinverni R14, Moradpour D15, Heim M16, Trincucci G17, Rubbia-Brandt L2, Negro F1,2; BOSTIC Study Group. J Viral Hepat. 2018 Mar 13. doi: 10.1111/jvh.12891. [Epub ahead of print] |
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Author information
Abstract
It remains unclear whether hepatitis B virus (HBV) infection may modify the severity of viral steatosis in patients coinfected with chronic hepatitis C virus (HCV). We examined the influence of coinfection with HBV on prevalence of steatosis in chronic hepatitis C in a multi-center cohort of HBV-HCV subjects, and by performing a systematic review and meta-analysis of the literature. We centrally and blindly assessed steatosis prevalence and severity in a cohort of HBV-HCV coinfected subjects compared to HCV and HBV monoinfected controls and we performed a systematic review of studies addressing the prevalence of steatosis in HBV-HCV subjects compared to HCV controls. In the clinical cohort, we included 85 HBV-HCV, 69 HBV and 112 HCV subjects from 16 international centers. There was no significant difference in steatosis prevalence between the HBV-HCV and the HCV groups (33% vs 45%, p=0.11). In subgroup analysis, lean HBV-HCV subjects with detectable HBV DNA had less steatosis than lean HCV subjects matched for HCV viremia (15% vs 45%, p=0.02). Our literature search identified 5 additional studies included in a systematic review. Overall, prevalence of steatosis > 5% was similar in HBV-HCV infection compared to HCV (pooled odds ratio [OR] 0.91, 95% CI 0.53-1.6) although there was significant heterogeneity (I2 69%, p = 0.007). In conclusion, although the prevalence of steatosis is similar in HBV-HCV compared to HCV subjects, our analysis suggests that there may be an inhibitory effect of HCV-induced steatogenesis by HBV in certain subgroups of patients.
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