Concurrent MASLD and Long-term Outcomes in HBV-infected Individuals: A Population-based Cohort Study

Area of Science:

• Hepatology
• Cardiology
• Oncology

Background:

• Chronic hepatitis B virus (HBV) infection is a global health concern.
• Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasingly prevalent.
• The interplay between MASLD and long-term outcomes in HBV patients requires further investigation.

Purpose of the Study:

• To examine the influence of MASLD on long-term outcomes in patients with chronic HBV infection.
• To assess the independent and interactive associations between steatotic liver disease (SLD), cardiometabolic risk factors (CMRFs), and HBV infection.

Main Methods:

• A cohort study involving 3,269 participants with chronic HBV infection.
• Median follow-up of 13.7 years.
• Inclusion of 120,913 individuals without HBV infection for comparative analysis.

Main Results:

• MASLD was not associated with primary liver cancer in HBV patients.
• MASLD increased the risk of extrahepatic cancers (HR=1.50) and cardiovascular diseases (HR=1.98) in HBV patients.
• A significant synergistic interaction was found between HBV infection, CMRFs, and primary liver cancer.

Conclusions:

• MASLD is a critical indicator of elevated systemic risk in chronic HBV patients.
• Addressing both virological control and metabolic health is essential for managing HBV patients.
• The findings underscore the importance of metabolic health management irrespective of hepatic steatosis or liver enzyme status.