Hepatitis B virus activity is not associated with degree of liver steatosis in patients with hepatitis B-related chronic liver disease Response

Background & Aims The recently published manuscript by Zhu and colleagues "Hepatitis B virus infection and risk of non-alcoholic fatty liver disease: A population-based cohort study" found no correlation between presence of chronic HBV and presence of common risk factors for non-alcoholic fatty liver disease on primary analysis. A limitation to this study, like most population based research, is the absence of liver histology, which is considered gold standard for assessment of non-alcoholic fatty liver disease. Methods Our group studied the association between hepatitis B viral activity and non-alcoholic fatty liver disease activity as measured by grade of steatohepatitis/fibrosis on liver biopsy by analysing consecutive liver histology samples from patients with chronic hepatitis B at a single quaternary liver transplant centre. Results Linear regression modelling for active viral hepatitis on histological examination against degree of steatohepatitis showed no correlation (r(2) = .018, all P> .1). Linear regression of degree of steatohepatitis vs hepatitis B viral load also showed no correlation. Conclusions Our work is concordant with the manuscript from Zhu et al; we found no significant correlation between hepatitis B viral activity and degree of steatohepatitis.