Host and Viral Factors Influencing Liver Fibrosis in Chronic HBV Patients with or without Superimposed Steatosis

Abstract

In chronic hepatitis B (CHB), the presence of hepatic fibrosis (HF) seems to be associated with known host and viral factors which may influence the long-term prognosis of CHB in the presence or absence of steatosis. We conducted an in-depth review of studies on the host and viral parameters in CHB patients, who acquired biopsy-proven liver fibrosis and we compared and contrasted the factors contributing to HF. In terms of host factors, the presence and stages of fibrosis did not correlate with the levels of FBS, bilirubin, triglyceride, the presence of steatosis, and body mass index. However, older age, prolonged prothrombin time, mild to severe hepatitis activity index (HAI) degree and hepatitis delta co-infection were associated with fibrosis. Other intermediate values for host factors such: as male gender, elevated liver enzyme tests, obesity and heavy alcohol consumption did not meet strong correlation with fibrosis, despite being more common in CHB patients with fibrosis. No significant correlation was found between viral factors (HBV DNA and HBeAg status) and the severity of fibrosis. The severity of fibrosis was not found to be associated with the degree of steatosis of liver in CHB. HF in CHB patients appears to be unrelated to virologic factors. However, fibrosis progression in CHB related to the variable host factors which could be enhanced through these factors in HBV chronic patients.