The relationship between the use of nucleos(t)ide analogs and metabolic parameters in patients with chronic hepatitis B

- OBJECTIVE: In the treatment of chronic hepatitis-B (CHB), although viral rep-lication load is reduced with the use of nucle-os(t)ide analogs, the risk of cirrhosis and hepa-tocellular carcinoma (HCC) remains. We aimed to investigate the relationship between metabol-ic syndrome (MetS) and CHB of nucleos(t)ide an-alogs, which are effective in mortality-morbidity. PATIENTS AND METHODS: In patients who applied to the gastroenterology outpatient clin-ic between 2021 and 2022, we compared inac-tive HBsAg-positive patients who did not receive treatment with nucleos(t)ide analogs [entecavir (ETV), lamivudine (LAM), tenofovir disoproxil fu-marate (TDF), tenofovir alafenamide (TAF)] and medical treatment. Demographic characteristics of the patients were recorded. Lipid profile, He-moglobin A1c (HbA1c), and HOMA-IR were re-corded. The presence of hepatosteatosis was graded ultrasonographically. APRI, Forns Index, and FIB-4 score, which are indicators of non-in-vasive liver fibrosis, were evaluated. RESULTS: Of the 265 patients, 55.5% (n=147) were males and 44.5% (n=118) were females. The ages of the participants ranged from 18 to 80, with a mean age of 46.54 +/- 14.03. It was observed that 62.3% (n=165) of the cases received medical treat-ment. When the drugs used by those receiving medical treatment were examined, 70.3% (n=116) TDF, 6.1% (n=10) TAF, 3% (n=5) LAM, and 20.6% (n=34) ETV, LDL, HDL, and total cholesterol mea-surement values of those who received medical treatment were lower, while HOMA-IR values were higher compared to those who did not receive the medical treatment. While the HbA1c value of the patients using ETV was found to be high, the liv-er stiffness indicator scores of those using TDF were found to be significantly higher. CONCLUSIONS: In this study, in patients with CHB, it has been shown that medical treatment also affects MetS parameters.