There may be an inhibitory effect of hepatitis C virus (HCV)-induced steatogenesis by hepatitis B virus (HBV) in certain subgroups of patients, according to a large, multicenter, retrospective cohort study published in the Journal of Viral Hepatitis.
Although the clinical association between steatosis and HCV infection is well established, the association between steatosis and chronic HBV infection and whether HBV affects the severity of viral steatosis in patients coinfected with chronic HCV is less clear. Therefore, researchers performed a systematic review and meta-analysis of the literature to examine the impact of coinfection with HBV on prevalence of steatosis in chronic HCV. They identified 85 patients coinfected with HBV and HCV, 69 patients infected with HBV, and 112 patients infected with HCV (controls). They found no significant difference in steatosis prevalence between the HBV/HCV coinfected and HCV monoinfected groups (33% vs 45%, respectively, P =.11).
However, people coinfected with HBV/HCV who had detectable and quantifiable serum HBV DNA had significantly less steatosis compared with patients with HCV. This was confirmed in a subgroup analysis in lean patients with detectable HBV DNA matched with lean patients with HCV for serum HCV RNA levels (15% vs 45%, respectively, P =.03).
“In conclusion, we have shown that there is no major difference in steatosis distribution between HBV/HCV coinfected subjects and HCV monoinfected subjects, although analysis of our clinical cohort also suggests that HBV may have a weak effect on lipid metabolic pathways affected by HCV, thus [having an impact on] viral steatosis,” stated the authors. Future studies are suggested to explain the effect of HBV/HCV coinfection in subjects with HCV genotype 3 and to further describe the impact of HBV on viral-induced steatosis.
Goossens N, de Vito C, Mangia A, et al. Effect of hepatitis B virus on steatosis in hepatitis C virus co-infected subjects: a multi-center study and systematic review [published online March 13, 2018]. J Viral Hepat. doi: 10.1111/jvh.12891