Clinical effect of entecavir in treatment of chronic hepatitis B complicated by hepatic steatosis

Objective To investigate the effect of antiviral therapy with entecavir in the treatment of chronic hepatitis B (CHB) complicated by hepatic steatosis.Methods A total of 164 HBe Ag-positive CHB patients who visited Bazhou People's Hospital from June 2014 to June2015 were enrolled, and according to the percentage of hepatocytes with steatosis in the hepatic lobules in all hepatocytes, they were divided into control group (<5% 43="" 89="" of="" hepatocytes="" with="" group="" a="" and="" b="">30% of hepatocytes with steatosis, 32 patients) .All patients were treated with entecavir.The serum virological parameters and liver function parameters were measured before treatment and at weeks 24 and 48 of treatment.A one-way analysis of variance was used for comparison of continuous data between groups, and the Bonferroni method was used for comparison between any two groups;the chi-square test was used for comparison of categorical data between groups.Results Hepatic steatosis did not affect the virologic response at week 24 of entecavir treatment (P>0.05) .However at week 48 of entecavir treatment, compared with the control group, group B had significantly lower HBe Ag clearance rate (34.4% vs 60.2%, P=0.012) and HBV DNA clearance rate (40.6% vs 67.4%, P=0.008) .At weeks 24 and 48 of entecavir treatment, compared with the control group, groups A and B had a significantly lower alanine aminotransferase normalization rate than the control group (group A:P=0.013 and 0.001;group B:P=0.001 and P<0.001) and significantly higher levels of aspartate aminotransferase, alkaline phosphatase, and gamma-glutamyl transpeptidase (group A:P24<0.001, P24=0.031, and P24=0.001, P48<0.001, P48=0.021, and P48<0.001;group B:P24<0.001, P24=0.028, and P24=0.001, P48<0.001, P48=0.017, P48<0.001) .conclusion="" a="" percentage="" of="" hepatocytes="" with="" steatosis="">30% is associated with the reduction in virologic response at week48 of entecavir treatment.Hepatic steatosis affects the biochemical response in CHB patients at weeks 24 and 48 of entecavir treatment.