Hepatic Steatosis in Chronic Hepatitis B as Measured by Controlled Attenuation Parameter: Frequency and Distribution

Objective: To determine the frequency of liver steatosis in chronic hepatitis B (CHB) patients measured by controlled attenuation parameter (CAP) and to describe the distribution of fibrosis and inflammation in different steatosis grading. Study Design: Cross-sectional study. Place and Duration of Study: Department of Infectious Diseases and Hepatology, The Second Hospital of Shandong University, Jinan, China, from January 2017 to December 2018. Methodology: CHB patients who were evaluated with transient elastography (TE) for liver fibrosis and steatosis were included. Liver biochemical testing was performed within 3 days of TE measurements. Steatosis grading was assessed as SO (no steatosis, CAP 0-247 dB/m), 51 (mild steatosis, CAP 248-267 dB/m), S2 (moderate steatosis, CAP 268-279 dB/m) and S3 (severe steatosis, CAP >=280 dB/m). Statistically comparisons of continuous variables or percentages were performed. Results: A total of 1,621 CHB patients were included. The frequencies of liver steatosis in CHB patients were 35.4% (574 patients), of which 314 patients (19.3%) were diagnosed as severe steatosis (grading S3). Comparisons of age, gender and liver fibrosis in different steatosis grading revealed no statistical differences (p=0.109, 0.075 and 0.269, respectively). However, ALT values in patients with severe steatosis (grading S3) were higher than those patients with steatosis grading S0 (p<0.001) and S2 (p=0.047). Conclusion: Steatosis is common in CHB patients. Liver fibrosis seemed not discrepant in different steatosis grading. More obvious hepatic inflammation is seen in CHB patients with severe steatosis.