Dynamics of liver stiffness in chronic hepatitis B patients with concurrent metabolic-associated fatty liver disease

We read with interest the article by Mak et al.1 and commend their work exploring the diverse relationship between hepatic steatosis and chronic hepatitis B (CHB). Through prospective follow-up of 330 patients with normal alanine aminotransferase (ALT) and low viraemia, Mak et al. showed persistent severe steatosis (controlled attenuation parameter ≥280 dB/m) was associated with progression of fibrosis category after three years. As modern nucleos(t)ide analogues are able to achieve effective long term viral/biochemical suppression and attenuate fibrosis development,2 the focus of CHB management has shifted to address non-viral risk factors such as concurrent steatosis—with approximately 30% prevalence amongst patients with CHB3—and metabolic-associated fatty liver disease (MAFLD).
Source: Journal of Hepatology - Category: Gastroenterology Authors: Tags: Letter to the Editor Source Type: research