Hepatic Steatosis in Chronic Hepatitis B as Measured by Controlled Attenuation Parameter: Frequency and Distribution

To determine the frequency of liver steatosis in chronic hepatitis B (CHB) patients measured by controlled attenuation parameter (CAP) and to describe the distribution of fibrosis and inflammation in different steatosis grading.

Cross-sectional study.

Department of Infectious Diseases and Hepatology, The Second Hospital of Shandong University, Jinan, China, from January 2017 to December 2018.

CHB patients who were evaluated with transient elastography (TE) for liver fibrosis and steatosis were included. Liver biochemical testing was performed within 3 days of TE measurements. Steatosis grading was assessed as S0 (no steatosis, CAP 0-247 dB/m), S1 (mild steatosis, CAP 248-267 dB/m), S2 (moderate steatosis, CAP 268-279 dB/m) and S3 (severe steatosis, CAP >=280 dB/m). Statistically comparisons of continuous variables or percentages were performed.

A total of 1,621 CHB patients were included. The frequencies of liver steatosis in CHB patients were 35.4% (574 patients), of which 314 patients (19.3%) were diagnosed as severe steatosis (grading S3). Comparisons of age, gender and liver fibrosis in different steatosis grading revealed no statistical differences (p=0.109, 0.075 and 0.269, respectively). However, ALT values in patients with severe steatosis (grading S3) were higher than those patients with steatosis grading S0 (p<0.001) and S2 (p=0.047).

Steatosis is common in CHB patients. Liver fibrosis seemed not discrepant in different steatosis grading. More obvious hepatic inflammation is seen in CHB patients with severe steatosis.