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Publications

Journal Article Ahead of print 2 citations

PubMed: 42419754 DOI: 10.1111/jgh.70533

Chronic Viral Hepatitis With MASLD: Implications for Clinical and Patient-Reported Outcomes.

J Gastroenterol Hepatol

Authors: George Papatheodoridis, Maria Buti, Yusuf Yilmaz, Ming-Lung Yu, Mohamed El-Kassas, Khalid Alswat, Marlen Ivon Castellanos Fernandez, Yuichiro Eguchi, Ajay Duseja, Caglayan Keklikkiran, Saeed Hamid, Wah Kheong Chan, Stuart C Gordon, Stuart K Roberts, Jacob George, Ashwani K Singal, Aijaz Ahmed, Brian Lam, Fatema Nader, Linda Henry, Maria Stepanova, Saleh A Alqahtani, Zobair M Younossi

Affiliations

  • The Global NASH/MASH and Global Liver Councils, Washington, DC, USA.
  • 1st Department of Gastroenterology, National/Kapodistrian University of Athens, Athens, Greece.
  • Vall d'Hebron University Hospital, Barcelona, Spain.
  • Department of Gastroenterology, School of Medicine, Recep Tayyip Erdoğan University, Rize, Türkiye.
  • Center of Excellence for Metabolic Associated Fatty Liver Disease, National Sun Yat-Sen University, Kaohsiung, Taiwan.
  • Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital and Center of Metabolic Disorders and Obesity, Kaohsiung Medical University, Kaohsiung, Taiwan.
  • Endemic Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt.
  • Applied Science Research Center, Applied Science Private University, Amman, Jordan.
  • King Saud University, Riyadh, Saudi Arabia.
  • University of Medical Sciences of Havana, Havana, Cuba.
  • Loco Medical General Institute, Saga, Japan.
  • Postgraduate Institute of Medical Education & Research, Chandigarh, India.
  • Aga Khan University, Karachi, Pakistan.
  • University of Malaya, Kuala Lumpur, Malaysia.
  • Henry Ford Health System, Detroit, Michigan, USA.
  • Alfred Hospital, Melbourne, VIC, Australia.
  • The University of Sydney, Sydney, New South Wales, Australia.
  • University of Louisville, Louisville, Kentucky, USA.
  • Stanford University School of Medicine, Palo Alto, California, USA.
  • Center for Outcomes Research in Liver Disease, Washington, DC, USA.
  • King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
  • The Global Center for Liver Outcomes and Policy Research, Georgetown University School of Medicine, Washington, DC, USA.

Abstract

BACKGROUND

Hepatitis B virus (HBV), hepatitis C virus (HCV), and metabolic dysfunction-associated steatotic liver disease (MASLD) are common liver diseases. Clinical characteristics and patient-reported outcomes (PROs) of HBV and HCV patients with/without superimposed MASLD were evaluated.

METHODS

Cross-sectional study of clinical and PRO (FACIT-Fatigue [FACIT-F], Chronic Liver Disease Questionnaire [CLDQ], Work Productivity and Activity Impairment [WPAI] questionnaire) data from Global Liver Registry, HBV and HCV patients. MASLD was defined as Hepatic Steatosis Index (HSI) ≥ 36 with ≥ 1 cardiometabolic risk factor (overweight, type 2 diabetes, hypertension, and hyperlipidemia).

RESULTS

Among 4649 subjects, 2063 had HBV (48 ± 13 years; 57% male; 11% advanced fibrosis; 49% MASLD); 2586 had HCV (56 ± 14 years; 47% male; 18% advanced fibrosis; 47% MASLD). HBV with/without MASLD were similar in age, sex, and noncardiometabolic comorbidities (all p > 0.05) but those with MASLD had more advanced fibrosis (p < 0.01) and significantly lower PRO scores: FACIT-F Physical Well-Being and Fatigue domains and all CLDQ (all p < 0.01) especially Fatigue domain (6% reduction in score range). HCV patients with MASLD were younger, more frequently female (p < 0.01) with similar rates of advanced fibrosis, biopsy-proven cirrhosis, and noncardiometabolic comorbidities (all p > 0.05). They had significantly lower scores in FACIT-F Physical Well-Being and all CLDQ domains (all p < 0.01); the greatest impairment was in Systemic Symptoms and Worry domains (6% reduction in score range). MASLD was independently associated with lower CLDQ scores in multivariate analysis (p < 0.05).

CONCLUSIONS

Approximately half of HBV or HCV patients had MASLD and reported significantly worse PROs, highlighting the importance of proactive metabolic assessment and management in patients with chronic viral hepatitis.

MeSH

Liver Diseases, Comorbidity, Gastroenterology, Fibrosis, Liver, Fatigue, Viruses, Patient Reported Outcome Measures, Hepatitis