Clinical profiles and their interaction of concurrent metabolic associated steatotic liver disease and hepatitis B virus infection

BACKGROUND A new nomenclature of metabolic associated steatotic liver disease(MASLD)was proposed in 2023,thus expanding the diagnostic name of“MASLD combined with other etiologies”.AIM To investigate the clinical profiles of patients with concurrent MASLD and ch-ronic hepatitis B virus(HBV)infection.METHODS This study included participants from the Taiwan Bio-bank.The diagnostic cri-teria of MASLD encompassed hepatic steatosis and any cardio-metabolic risk factors.Positive hepatitis B surface antigen was considered indicative of chronic HBV infection.Dual etiology was defined as MASLD combined with chronic HBV infection(MASLD-HBV).Fibrosis 4(FIB-4)score determined the severity of liver fibrosis,and athero-sclerosis was diagnosed by the presence of carotid plaques on duplex ultrasound.RESULTS In a total of 18980 participants(mean age,55.18±10.35 years;males,30.42%),there were 7654(40.3%)MASLD patients and 2128(11.2%)HBV carriers.After propensity score matching for age and gender,HBV carriers had a lower percentage of MASLD than healthy controls.Those with dual etiology had higher aspartate aminotrans-ferase,alanine aminotransferase(ALT),and FIB-4 levels,but lower gamma glutamyl transferase(GGT)levels than MASLD patients.In contrast,those with dual etiology had higher ALT and GGT levels,but lower FIB-4 than“HBV alone”patients.The risk of atherosclerosis was similar among these three groups.CONCLUSION MASLD-HBV patients have worse liver fibrosis severity than MASLD patients,but better liver fibrosis stage than“HBV alone”patients,suggesting a complex interaction between MASLD and chronic HBV infection.