Emin BODAKCI, Saba KIREMITCI, Zeynep MELEKOGLU ELLIK, Ozge KOC, Mesut GUMUSSOY, Volkan YILMAZ, Hale GOKCAN, Atilla Halil ERHAN, Sevinc Tugce GUVENIR, Ramazan Erdem ER, Berna SAVAS, Ramazan IDILMAN
Hepatology Forum - 2026;7(1):14-20
Background and Aim: The present study aimed to determine the effect of hepatic steatosis, as detected by liver biopsy, on Hepatitis B surface antigen (HbsAg) seroclearance and disease progression in patients infected with hepatitis B virus (HBV). Materials and Methods: Patients with chronic HBV infection and chronic hepatitis B (CHB) from an existing cohort of HBV-infected patients were enrolled. Results: This study included 296 patients: 186 with chronic HBV infection and 110 with CHB. Patients with chronic HBV infection were older (p=0.006), and exhibited a higher prevalence of wild-type mutants (p<0.001). At the baseline liver biopsy, 31% of the patients had hepatosteatosis. Thirty-two patients (11%) achieved HBsAg loss during the follow-up period; 72% had HBsAg seroconversion to anti-HBs. Multivariable Cox regression showed that the stage of HBV disease (chronic HBV infection vs. CHB) (Hazard ratio [HR]: 6.385, Confidence interval [CI]: 1.513-26.941, p=0.012) and grading of hepatosteatosis at baseline liver biopsy (HR: 4.699, CI: 1.662-13.286, p=0.004) were predictors of HBsAg seroclearance. Conclusion: Hepatic steatosis was associated with a functional cure for chronic HBV infection; however, it also causes disease progression in HBV-infected patients.
