Metabolic syndrome association with fibrosis development in chronic hepatitis B virus inactive carriers

Authors

  • Álvaro Mena,

    Corresponding author
    1. Grupo de Virología Clínica, Instituto de Investigación Biomédica (INIBIC), Complejo Hospitalario Universitario de A Coruña (CHUAC), Sergas, La Coruña, Spain
    • Correspondence

      Mr Álvaro Mena, Grupo de Virología Clínica, Instituto de Investigación Biomédica (INIBIC), Complejo Hospitalario Universitario de A Coruña (CHUAC), Sergas, Avda Xubias de Arriba 84, 15006, A Coruña, Spain. Email: alvaro.mena.de.cea@sergas.es

    Search for more papers by this author
  • José D Pedreira,

    1. Grupo de Virología Clínica, Instituto de Investigación Biomédica (INIBIC), Complejo Hospitalario Universitario de A Coruña (CHUAC), Sergas, La Coruña, Spain
    Search for more papers by this author
  • Ángeles Castro,

    1. Grupo de Virología Clínica, Instituto de Investigación Biomédica (INIBIC), Complejo Hospitalario Universitario de A Coruña (CHUAC), Sergas, La Coruña, Spain
    Search for more papers by this author
  • Soledad López,

    1. Grupo de Virología Clínica, Instituto de Investigación Biomédica (INIBIC), Complejo Hospitalario Universitario de A Coruña (CHUAC), Sergas, La Coruña, Spain
    Search for more papers by this author
  • Pilar Vázquez,

    1. Grupo de Virología Clínica, Instituto de Investigación Biomédica (INIBIC), Complejo Hospitalario Universitario de A Coruña (CHUAC), Sergas, La Coruña, Spain
    Search for more papers by this author
  • Eva Poveda

    1. Grupo de Virología Clínica, Instituto de Investigación Biomédica (INIBIC), Complejo Hospitalario Universitario de A Coruña (CHUAC), Sergas, La Coruña, Spain
    Search for more papers by this author

  • Conflict of interests: None to declare.

Abstract

Background and Aim

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.

Conclusion

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.

Ancillary