AT A GLANCE

A new study published in EClinicalMedicine reports that the presence and number of metabolic diseases can influence the chronic hepatitis B response to antiviral treatment.¹

“Metabolic dysfunction is associated with liver disease, but it is unclear if it would impact responses to antiviral treatment in chronic hepatitis B (CHB) patients,” explain study authors Huang et al.

A total 4507 treatment-naïve CHB patients from 32 centers who initiated nucleos(t)ide analogs (NAs) between January 2004 and August 2024 were enrolled and propensity-score matched (PSM) to balance the backgrounds of patients with and without metabolic disease (diabetes, obesity, dyslipidemia, or hypertension). The authors then compared their biochemical (BR), virologic (VR), and complete (CR) responses.

According to the authors, in the PSM cohort of 893 pairs of patients, patients with metabolic disease had significantly lower 5-year cumulative BR (91.3% vs. 95.8%) and CR rates (81.8% vs. 87.4%) but similar VR and hepatitis B(e) antigen seroconversion rates (27.0% vs. 29.7%). 

A multivariable Cox regression revealed that metabolic disease was associated with lower BR and CR rates, especially among those with at least three metabolic diseases.

“The presence and number of metabolic diseases were significantly and incrementally associated with lower BR. Metabolic disease should be taken into consideration in the management of CHB patients receiving NA treatment,” conclude the authors.

Reference

1.     Hhuang R, Jun DW, Toyoda H, et al. Impact of metabolic dysfunction on treatment responses to nucleos(t)ide analogues in chronic hepatitis B: a retrospective multi-center REAL-B cohort study. EClinicalMedicine. 2025:87:103407.