Diagnosing and defining MASLD in people living with chronic hepatitis B

Emily Martyn1,2,3, Alejandro Arenas-Pinto3,4, Richard Gilson3,4

  • 1The Francis Crick Institute, London, UK.

Insights

Chronic hepatitis B (CHB) and metabolic dysfunction-associated steatotic liver disease (MASLD) often coexist. This review examines diagnostic tools for MASLD in CHB patients, advocating for better consensus and care.

Area of Science:

  • Hepatology
  • Metabolic Disorders
  • Liver Disease Epidemiology

Background:

  • Chronic hepatitis B (CHB) and metabolic dysfunction-associated steatotic liver disease (MASLD) are significant global liver health concerns.
  • The interaction between CHB and MASLD is poorly understood due to evolving terminology and diagnostic inconsistencies.
  • Limited data exists on identifying MASLD and associated liver damage in CHB populations worldwide.

Purpose of the Study:

  • To review current diagnostic approaches for MASLD in patients with CHB.
  • To highlight challenges in diagnosis stemming from terminology changes and varied application of tools.
  • To advocate for standardized diagnostic criteria, monitoring, and equitable access to interventions.

Main Methods:

  • Systematic collation of data on diagnostic tests for MASLD in CHB patients.
  • Analysis of literature addressing the co-occurrence and impact of CHB and MASLD.
  • Review of global population data and diagnostic tool application.

Main Results:

  • Inconsistent application of diagnostic tools hinders accurate MASLD identification in CHB.
  • Lack of consensus on diagnostic criteria complicates risk stratification and management.
  • Significant gaps exist in understanding the global burden and interaction of these conditions.

Conclusions:

  • Improved consensus on diagnosing MASLD in CHB patients is crucial.
  • Evidence-based monitoring and risk stratification strategies are needed.
  • Enhanced access to interventions and reduced health inequities are essential for managing co-existing CHB and MASLD.

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