Metabolic dysfunction-associated fatty liver disease increases risk of adverse outcomes in patients with chronic hepatitis B

•Recently, MAFLD was defined as hepatic steatosis in the presence of metabolic dysfunction (e.g. overweight, diabetes).•In patients with chronic hepatitis, MAFLD was associated with reduced event-free (p <0.001), HCC-free (p <0.001), and transplant-free survival (p <0.001).•Among patients with MAFLD, risk of adverse outcomes was similar for patients with and patients without steatohepatitis.•Our findings underscore the importance of metabolic dysfunction in patients with CHB.