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World J Gastroenterol. Jun 21, 2014; 20(23): 7213-7216
Published online Jun 21, 2014. doi: 10.3748/wjg.v20.i23.7213
Association between metabolic factors and chronic hepatitis B virus infection
Chien-Hsieh Chiang, Kuo-Chin Huang
Chien-Hsieh Chiang, Kuo-Chin Huang, Department of Family Medicine, National Taiwan University Hospital and College of Medicine, Taipei 100, Taiwan
Chien-Hsieh Chiang, Department of Community and Family Medicine, National Taiwan University Hospital Yun-Lin Branch, Yunlin 640, Taiwan
Kuo-Chin Huang, Graduate Institute of Clinical Medical Science, China Medical University, Taichung 404, Taiwan
Author contributions: Chiang CH and Huang KC designed the study and wrote the article.
Correspondence to: Kuo-Chin Huang, MD, PhD, Professor, Head, Department of Family Medicine, National Taiwan University Hospital and College of Medicine, 7 Chung Shan South Road, Taipei 100, Taiwan. bretthuang@ntu.edu.tw
Telephone: +886-2-23123456 Fax: +886-2-23118674
Received: October 23, 2013
Revised: December 29, 2013
Accepted: February 26, 2014
Published online: June 21, 2014
Abstract

There are limited data regarding the relationship between chronic hepatitis B virus (HBV) infection and metabolic factors. This article aims to highlight the link of metabolic factors with hepatitis B surface antigen (HBsAg) serostatus, HBV load, and HBV-related hepatocellular carcinoma (HCC). Although HBsAg-positive serostatus was positively correlated with a high risk of metabolic syndrome in students, chronic HBV-infected individuals have high serum adiponectin levels. The androgen pathway in HBV carriers with a low body mass index is more triggered which leads to enhanced HBV replication. High HBV load was inversely associated with obesity in hepatitis B e antigen (HBeAg)-seropositive HBV carriers; while in HBeAg-seronegative HBV carriers, high HBV load was inversely related to hypertriglyceridemia rather than obesity. For overweight and obese HBV-infected patients, high HBV load was positively associated with serum adiponectin levels. Several large cohort studies have revealed a positive link of diabetes with incidence of HBV-related HCC. However, the association between incidence of HCC and metabolic factors other than diabetes is still inconclusive. More long-term prospective studies should elucidate the association of chronic HBV infection and its outcomes with metabolic factors in clinical practice.

Keywords: Hepatitis B surface antigen, Hepatitis B viral load, Hepatocellular carcinoma, Diabetes, Obesity, Adiponectin

Core tip: Facing the increasing burden of metabolic syndrome and chronic hepatitis B worldwide, this review tries to highlight the association of metabolic factors with chronic hepatitis B. Intriguingly, hepatitis B virus carriers are reported to have higher serum adiponectin levels, previously linked with individuals with low body mass index. Obesity and hypertriglyceridemia (metabolically bad factors) are inversely associated with high hepatitis B viral load; a crucial predictor for primary liver cancer. In contrast, serum adiponectin levels (a metabolically good factor) are positively related to high hepatitis B viral load in individuals with high body mass index.