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Antibody to hepatitis B virus core antigen positivity is a predictor of non-alcoholic fatty liver disease severity

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Abstract

Insufficient information is available about co-factors favoring the progression of non-alcoholic fatty liver disease (NAFLD) toward cirrhosis. We aimed to evaluate the impact of a limited alcohol intake and of occult hepatitis B virus (HBV) infection (OBI) on the severity of NAFLD. Three-hundred-seventy-four alcohol non-abusers and HBV surface antigen negative NAFLD patients (223 males; mean age 55.4 years), consecutively admitted to the outpatients clinic of a referral liver unit from January 1st, 2018 to December 31st, 2019, were studied. Anti-HBV core antigen antibody [(anti-HBc), a surrogate marker of OBI] was assessed in all patients. Patients were distinguished between teetotal and moderate alcohol consumers (intake of less than 30 g and 20 g if males or females, respectively). Liver fibrosis was non-invasively assessed by FIB-4 and transient elastography. Uni- and multivariate analyses were performed to identify predictors of advanced fibrosis. Patients had a mean BMI of 28.5 kg/m2, and the majority presented metabolic and cardio-vascular comorbidities [258 patients (69%) had insulin resistance/diabetes, 249 (66.6%) dyslipidemia, 200 (53.5%) arterial hypertension]. Multivariate analysis showed that anti-HBc positivity (p = 0.046, OR 2.153) was a factor associated with advanced fibrosis at FIB-4 score testing, whereas moderate alcohol intake was not associated with severe NAFLD both at FIB-4 and transient elastography evaluations. The study showed that a moderate alcohol intake has no impact on NAFLD severity and suggested that OBI might negatively affect the NAFLD outcome.

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Funding

No funding was received for conducting this study.

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Authors and Affiliations

  1. Division of Medicine and Hepatology, University Hospital of Messina, Messina, Italy

    Carlo Saitta, Alessia Caruso, Sergio Maimone, Roberto Filomia, Irene Cacciola, Gaia Caccamo, Maria Stella Franzè, Concetta Pitrone & Giovanni Raimondo

  2. Division of Medicine and Hepatology, Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria, 1, 98124, Messina, Italy

    Carlo Saitta, Alessia Caruso, Irene Cacciola, Maria Stella Franzè, Concetta Pitrone, Giuseppe Mandraffino, Giovanni Squadrito & Giovanni Raimondo

  3. Division of Statistical and Mathematical Sciences, Department of Economics, University of Messina, Messina, Italy

    Angela Alibrandi

  4. Division of Diagnostic Imaging, Department of Biomedical and Dental Sciences and of Morphologic and Functional Imaging, University of Messina, Messina, Italy

    Michele Gaeta

  5. Division of Internal Medicine, University Hospital of Messina, Messina, Italy

    Giuseppe Mandraffino & Giovanni Squadrito

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  1. Carlo Saitta
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  2. Alessia Caruso
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  9. Angela Alibrandi
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Correspondence to Carlo Saitta.

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The study was approved by the Ethics Committee of the Messina University Hospital.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Saitta, C., Caruso, A., Maimone, S. et al. Antibody to hepatitis B virus core antigen positivity is a predictor of non-alcoholic fatty liver disease severity. Intern Emerg Med 17, 1609–1616 (2022). https://doi.org/10.1007/s11739-022-02971-5

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