Metabolic syndrome association with fibrosis development in chronic hepatitis B virus inactive carriers.
OBJECTIVE
There are few data of fibrosis development in chronic hepatitis B (CHB) patients classified as inactive carriers. The aim of this study is to determinate the prevalence of significant fibrosis and probable cirrhosis measured by FibroScan in real inactive CHB carriers and investigate the relationship with virological, epidemiological, and metabolic factors.


METHODS
Cross-sectional cohort study including CHB inactive carriers. Liver stiffness measurement was performed with transient elastography (FibroScan). Significant fibrosis (≥ F2) was defined as stiffness > 7.5 kPa, and probable cirrhosis as > 11.8 kPa. Factors associated with significant fibrosis were explored with univariate and multivariate adjusted logistic regression analyses.


RESULTS
Ninety-six CHB inactive carriers were analyzed. Of them, 24 (25%) had significant fibrosis and 7 (7%) probable cirrhosis; mean stiffness was 6.2 ± 2.3 kPa. Of them, 24% had metabolic syndrome, with higher FibroScan value than those without (8.4 kPa vs 5.5 kPa, P < 0.001). Factors associated with significant fibrosis were (odds ratio, 95% confidence interval, P value): central obesity (7.1, 1.8-27.9, 0.005), elevated fasting glucose (4.3, 1.3-27.9, 0.036), reduced high-density lipoprotein cholesterol (5.2, 1.2-23.6, 0.032) and elevated triglycerides (6.2, 1.4-28.3, 0.019). Factors as age, sex, transaminases, hepatitis B virus DNA or genotype were not related with liver fibrosis. The presence of metabolic syndrome has a 69% of positive predictive value and 89% of negative predictive value for significant fibrosis.


CONCLUSIONS
Different components of metabolic syndrome are associated with fibrosis development in CHB inactive carriers. In the absence of metabolic syndrome, significant fibrosis is uncommon in this population.
Grupo de Virología Clínica, Instituto de Investigación Biomédica (INIBIC), Complejo Hospitalario Universitario de A Coruña (CHUAC), Sergas, La Coruña, Spain.
Álvaro
Á
Mena
José D
JD
Pedreira
Ángeles
Á
Castro
Soledad
S
López
Pilar
P
Vázquez
Eva
E
Poveda
D000328:Adult; D000368:Aged; D002353:Carrier State; D003430:Cross-Sectional Studies; D054459:Elasticity Imaging Techniques; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications*; D006801:Humans; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications*; D008875:Middle Aged; D012044:Regression Analysis; D012189:Retrospective Studies; D014775:Virus Activation
FibroScan; HBV; fibrosis; inactive carriers; metabolic syndrome