IDDF2018-ABS-0027 Influence of hepatic steatosis on the treatment outcomes of entecavir and tenofovir in patients with chronic hepatitis B

Background The influence of hepatic steatosis (HS) on chronic hepatitis B (CHB) is not well-known. We evaluated the influence of HS, assessed using controlled attenuated parameter (CAP) of transient elastography (TE), on the treatment outcomes in CHB patients who initiated antiviral therapy (AVT). Methods Among 1,658 CHB patients who initiated AVT using entecavir or tenofovir between 2007 and 2016, 334 patients with available TE results at the time of initiating AVT were recruited. The cutoff CAP value for the diagnosis of HS was 238 dB/m. Results Of the study population, 146 (43.7%) patients had HS. During the follow-up period (median 38.6 months), 303 (90.7%) and 25 (7.5%) patients experienced complete virological response (CVR) (HBV DNA p=0.380). However, lower CAP value was independently associated with the higher probability of CVR achievement (hazard ratio [HR]=0.996; p=0.004) and HBeAg loss among HBeAg positive patients (HR=0.989; p=0.031). The cumulative incidence of HBeAg loss among HBeAg positive patients was significantly higher in patients without HS than that of patients with HS (p=0.022, log-rank test). Conclusions The HS was not correlated with HCC development in patients who initiated AVT using entecavir and tenofovir. However, HS was negatively correlated with the risk of CVR achievement and HBeAg loss among HBeAg positive patients.