Natural history and non-invasive diagnosis and clinical management of chronic HBV infection overlapping with nonalcoholic fatty liver disease

Chronic HBV infection (CBI) overlapping with nonalcoholic fatty liver disease (NAFLD) is becoming more and more common. Most studies about the influence of overlapping with NAFLD on the natural history of CBI have shown that overlapping with NAFLD promotes not only the development of cirrhosis and hepatocellular carcinoma, but also all-cause mortality including death due to liver disease; however, some studies have reported different outcomes. The etiological diagnosis of liver injury in patients with CBI overlapping with NAFLD is a difficult issue in clinical practice, and liver histopathology is still the gold standard, while it is very important to explore noninvasive diagnostic methods. For patients with CBI overlapping with NAFLD, anti-HBV therapy should be given according to current diagnosis and treatment guidelines for CBI in addition to active prevention and treatment of NAFLD.