Influence on chronic hepatitis B combined with nonalcoholic fatty liver disease on the development of hepatocellular carcinoma and all-cause mortality: A meta-analysis

Abstract

Abstract: Objective To investigate chronic hepatitis B (CHB) combined with nonalcoholic fatty liver disease (NAFLD) on hepatocellular carcinoma (HCC) and all-cause mortality. Methods Literature search was conducted in CNKI, Wanfang Chinese Database, China Biomedical Literature Database (CBM), VIP Chinese Database and Pubmed, Cochrane, Embase English Database from the establishment of the database to December 2021, as well as the related literatures supplemented by manual reference search. RevMan5.3 and Stata16.0 were used for meta-analysis. Statistical analysis was performed for all the included studies. The random effect model was used if the heterogeneity was significant; The fixed effect model was used if the heterogeneity was not significant. The relative risk (RR) and its 95% confidence interval (95%CI) were used to investigate the association of NAFLD with the development of HCC and all-cause mortality in CHB patients, and the publication bias test and sensitivity analysis were carried out. Results A total of 9 literatures were included, 8 were about the influence of NAFLD on the risk of HCC in CHB patients and 3 were about the influence of NAFLD on all-cause mortality in CHB patients. The results showed that compared with the CHB group, the CHB combined with NAFLD group had a higher risk of HCC (RR=1.93, 95%CI: 1.05-3.55, P=0.04), but the risk of all-cause mortality in the two groups (RR=1.38, 95%CI: 0.34-5.69, P=0.65) was not significantly different. Conclusion In CHB patients, NAFLD increases the risk of HCC, but has no significant effect on the risk of all-cause mortality. More large-sample, high-quality, multicenter cohort studies are needed in the future.

Key words: Chronic hepatitis B, Nonalcoholic fatty liver disease, Hepatocellular carcinoma, All-cause mortality, Meta-analysis

SU Pei-hua, WEI Meng-ping, ZHAO Cai-yan. Influence on chronic hepatitis B combined with nonalcoholic fatty liver disease on the development of hepatocellular carcinoma and all-cause mortality: A meta-analysis[J]. Chinese Hepatolgy, 2023, 28(3): 299-304.

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