The relationship between the use of nucleos(t)ide analogs and metabolic parameters in patients with chronic hepatitis B

A. Yakut, M. Aladag

Department of Internal Medicine, Section of Gastroenterology, Istanbul Medipol University Medical School, Sefakoy Hospital, Istanbul, Turkey. aysun.yakut@istanbul.edu.tr

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• Gastroenterology
• Internal Medicine

OBJECTIVE: In the treatment of chronic hepatitis-B (CHB), although viral replication load is reduced with the use of nucleos(t)ide analogs, the risk of cirrhosis and hepatocellular carcinoma (HCC) remains. We aimed to investigate the relationship between metabolic syndrome (MetS) and CHB of nucleos(t)ide analogs, which are effective in mortality-morbidity.

PATIENTS AND METHODS: In patients who applied to the gastroenterology outpatient clinic between 2021 and 2022, we compared inactive HBsAg-positive patients who did not receive treatment with nucleos(t)ide analogs [entecavir (ETV), lamivudine (LAM), tenofovir disoproxil fumarate (TDF), tenofovir alafenamide (TAF)] and medical treatment. Demographic characteristics of the patients were recorded. Lipid profile, Hemoglobin A1c (HbA1c), and HOMA-IR were recorded. The presence of hepatosteatosis was graded ultrasonographically. APRI, Forns Index, and FIB-4 score, which are indicators of non-invasive liver fibrosis, were evaluated.

RESULTS: Of the 265 patients, 55.5% (n=147) were males and 44.5% (n=118) were females. The ages of the participants ranged from 18 to 80, with a mean age of 46.54±14.03. It was observed that 62.3% (n=165) of the cases received medical treatment. When the drugs used by those receiving medical treatment were examined, 70.3% (n=116) TDF, 6.1% (n=10) TAF, 3% (n=5) LAM, and 20.6% (n=34) ETV, LDL, HDL, and total cholesterol measurement values of those who received medical treatment were lower, while HOMA-IR values were higher compared to those who did not receive the medical treatment. While the HbA1c value of the patients using ETV was found to be high, the liver stiffness indicator scores of those using TDF were found to be significantly higher.

CONCLUSIONS: In this study, in patients with CHB, it has been shown that medical treatment also affects MetS parameters.

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