title: Relationship Between Hepatic Steatosis and the Elevation of Aminotransferases in HBV-Infected Patients With HBe-Antigen Negativity and a Low Viral Load.
abstract: Nonalcoholic fatty liver disease has been suggested to be associated with alanine aminotransferase (ALT) elevation in hepatitis B virus (HBV)-infected patients with HBe antigen (HBeAg)-negativity and a low HBV-DNA level. However, few studies have evaluated the association according to histological findings of the liver.Among a total of 198 HBV-infected patients who received a percutaneous liver biopsy, we studied the histological and laboratory findings of HBeAg-negative patients without receiving nucleoside/nucleotide analogues treatment (N = 70) in order to evaluate whether hepatic steatosis and its related metabolic disorders were associated with an elevation in ALT levels in HBeAg-negative patients.In HBeAg-negative patients with a high serum HBV-DNA level (≥2000 IU/mL), the level of HBV-DNA was the only significant factor related to ALT elevation. However, in HBeAg-negative patients with a low HBV-DNA level, the serum ferritin level, and histologically observed hepatic steatosis were significantly associated factors with ALT elevation. When we evaluated 2 metabolic variables (serum ferritin and fasting insulin) that are suggested to be relevant to the presence of progressive disease in Japanese patients, we found that the rate of metabolic disorders was significantly higher among patients with a high ALT level and a low HBV-DNA level than it was among those with other conditions. The triglyceride level and the frequency of moderate or severe hepatic steatosis were significantly higher in patients with a low HBV-DNA level than in those with a high HBV-DNA level.Histologically proven hepatic steatosis and its related metabolic disorders are suggested to be involved in the elevation of aminotransferases of HBeAg-negative patients, particularly those with low HBV-DNA levels.
authors.affiliation: From the Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
authors.forename: Hirayuki
authors.initials: H
authors.lastname: Enomoto
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Aizawa
authors.forename: Hiroki
authors.initials: H
authors.lastname: Nishikawa
authors.forename: Naoto
authors.initials: N
authors.lastname: Ikeda
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Sakai
authors.forename: Ryo
authors.initials: R
authors.lastname: Takata
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Hasegawa
authors.forename: Chikage
authors.initials: C
authors.lastname: Nakano
authors.forename: Takashi
authors.initials: T
authors.lastname: Nishimura
authors.forename: Kazunori
authors.initials: K
authors.lastname: Yoh
authors.forename: Akio
authors.initials: A
authors.lastname: Ishii
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Takashima
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Iwata
authors.forename: Hiroko
authors.initials: H
authors.lastname: Iijima
authors.forename: Shuhei
authors.initials: S
authors.lastname: Nishiguchi
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D004279:DNA, Viral / Q000097:blood; D005234:Fatty Liver / Q000175:diagnosis* / Q000473:pathology*; D005260:Female; D006513:Hepatitis B e Antigens / Q000097:blood*; D019694:Hepatitis B, Chronic / Q000175:diagnosis* / Q000473:pathology*; D006801:Humans; D008099:Liver / Q000473:pathology*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D013223:Statistics as Topic; D000637:Transaminases / Q000097:blood*; D019562:Viral Load
chemical_list: D004279:DNA, Viral; D006513:Hepatitis B e Antigens; D000637:Transaminases