November 16, 2013

Metabolic Syndrome Is Associated With Fibrosis Development In Chronic Hepatitis B Virus Inactive Carriers

Journal of Gastroenterology and Hepatology

Accepted Article (Accepted, unedited articles published online and citable. The final edited and typeset version of record will appear in future.)

Clinical Hepatology

Álvaro Mena*, José D Pedreira, Ángeles Castro, Soledad López, Pilar Vázquez,  Eva Poveda

DOI: 10.1111/jgh.12432

This article is protected by copyright. All rights reserved.

This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1111/jgh.12432

Publication History
Accepted manuscript online: 13 NOV 2013 05:42AM EST
Manuscript Accepted: 16 SEP 2013

Keywords: HBV;  inactive carriers;  metabolic syndrome; fibrosis;  FibroScan


Background and Aim

There are few data of fibrosis development in chronic hepatitis B (CHB) patients classified as inactive carriers. The aim of this study is to determinate the prevalence of significant fibrosis and probable cirrhosis measured by FibroScan in real inactive CHB carriers and investigate the relationship with virological, epidemiological and metabolic factors.


Cross-sectional cohort study including CHB inactive carriers. Liver stiffness measurement was performed with transient elastography (FibroScan). Significant fibrosis (≥F2) was defined as stiffness >7.5 kPa, and probable cirrhosis as >11.8 kPa. Factors associated with significant fibrosis were explored with univariate and multivariate adjusted logistic regression analyses.


96 CHB inactive carriers were analyzed. Of them, 24 (25%) had significant fibrosis and 7 (7%) probable cirrhosis; mean stiffness was 6.2±2.3 kPa.

Of them, 24% had metabolic syndrome, with higher FibroScan value than those without (8.4 kPa vs 5.5 kPa, p<0.001).

Factors associated with significant fibrosis were (odds ratio, 95% confidence interval, p value): central obesity (7.1, 1.8-27.9, 0.005), elevated fasting glucose (4.3, 1.3-27.9, 0.036), reduced HDL-cholesterol (5.2, 1.2-23.6, 0.032) and elevated triglycerides (6.2, 1.4-28.3, 0.019). Factors as age, sex, transaminases, HBV-DNA or genotype were not related with liver fibrosis.

The presence of metabolic syndrome has a 69% of positive predictive value and 89% of negative predictive value for significant fibrosis.


Different components of metabolic syndrome are associated with fibrosis development in CHB inactive carriers. In the absence of metabolic syndrome, significant fibrosis is uncommon in this population.


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