Kronik viral hepatitli olgularda kombine non-alkolik yağlı karaciğer hastalığının sıklığı ve önemi

Ferah Tuncel; Aslıhan Alpaslan Duman

doi:10.26559/mersinsbd.883097

Research Article

Kronik viral hepatitli olgularda kombine non-alkolik yağlı karaciğer hastalığının sıklığı ve önemi

Year 2021, Volume: 14 Issue: 1, 77 - 86, 30.04.2021

Ferah Tuncel Aslıhan Alpaslan Duman

https://doi.org/10.26559/mersinsbd.883097

Abstract

eden hepatosteatozun belirlenerek bunların skorlama sistemlerindeki parametreler ile ilişkisinin ortaya konması ve böylelikle hastalığın seyri ile ilgili öngörüde bulunmaktır. Yöntem: İki farklı üniversite hastanesinde kronik viral hepatit tanısı almış 110 olguya ait preperatlar yeniden değerlendirilmiş ve modifiye histolojik aktivite indeksi ve nonalkolik yağlı karaciğer hastalığı aktivite skoru (NAS) skorlama sistemleri esas alınarak skorlanmıştır. Bu iki skorlama sistemine ait parametreler arasındaki ilişki incelenmiştir. Bulgular: Hepatosteatoz, kronik hepatit C’li olgularımıza %34.8 oranında, kronik hepatit B olgularımıza ise %44.8 oranında eşlik etmektedir. Steatoz skoru arttıkça olgulara ait fibrozis skorları da artmaktadır. Sonuç: Sık görülen kronik karaciğer hastalıkları olan kronik viral hepatit ve nonalkolik yağlı karaciğer hastalığı (NAFLD) her zaman ayrı antiteler olarak kabul edilmemeli, birlikte görülebileceği de akılda tutulmalıdır. Kronik viral hepatitli olgulara eşlik eden steatohepatozun da patoloji raporlarında belirtilmesi hastalığın seyri açısından önem arz edecektir.

Keywords

kronik hepatit, nonalkolik yağlı karaciğer hastalığı, fibrozis

Supporting Institution

Project Number

Thanks

Verilerin istatistiksel analizini yapan Arş. Gör. Dr. Damla Hazal SUCU’ ya teşekkür ederiz

References

Kaynaklar 1. Liang J, Liu F, Wang F et al. A Noninvasive Score Model for Prediction of NASH in Patients with Chronic Hepatitis B and Nonalcoholic Fatty Liver Disease. Hindawi BioMed Research International 2017; 3: http://dx.doi.org/10.1155/2017/8793278.
2. Williams R. Global challenges in liver disease. Hepatology, 2006; 44 (3): 521–526.
3. Liu W, Baker RD, Bhatia T, Zhu L, Baker SS. Pathogenesis of nonalcoholic steatohepatitis, Cellular and Molecular Life Sciences. 2016; 73 (10): 1969–1987.
4. Minakari M, Molaei M, Shalmani HM, et al. Liver steatosis in patients with chronic hepatitis B infection: host and viral risk factors. European Journal of Gastroenterology and Hepatology. 2009; 21(5): 512–516.
5. Bondini S, Kallman J, Wheeler A, et al. Impact of nonalcoholic fatty liver disease on chronic hepatitis B. Liver International. 2007; 27 (5): 607–611.
6. Morales MA, Sendra C, Romero-Gomez M. Hepatitis B and NAFLD: Lives cossed. Annals of Hepatology.2017;16(2): 185-187.
7. Haga Y, Kanda T, Sasaki R, Nakamura M, Nakamoto S, Yokosuka O. Nonalcoholic fatty liver disease and hepatic cirrhosis: comparison with viral hepatitis-associated steatosis. World Journal of Gastroenterology.2015;21(16):12989-12995.
8. Yasui K, Harano Y, Mitsuyoshi H, et al. Steatosis and hepatic expression of genes regulating lipid metabolism in Japanese patients infected with hepatitis C virus. J Gastroenterol 2010; 45: 95-104.
9. Ishak K, Baptista A, Bianchi L, et al. Histological grading and staging of chronic hepatitis. J Hepatol 1995; 22: 696-699.
10. Kleiner DE, Brunt EM, Van Natta M, et al. Design and validation of a histological scoring sysytem for nonalcholic fatty liver disease. Hepatology. 2005;41:1313-1321.
11. Yilmaz B, Koklu S, Buyukbayram H, et al. Chronic hepatitis B associated with hepatic steatosis, insulin resistance, necroinflammation and fibrosis. Afri Health Sci. 2015;15(3):714-8. doi: http://dx.doi.org/10.4314/ahs.v15i3.3
12. Lavanchy D. Hepatitis B virus epidemiology, disease burden, treatment, and current and emerging prevention and control measures. J Viral Hepat 2004;11(2):97- 107.
13. Schiff E, Sorell M, Maddrey W. Disease of the Liver. 6th ed. Philadelphia: Lippincott-Williams and Wilkins; 1999.
14. Lonardo A, Loria P, Adinolfi LE, Carulli N, Ruggiero G. Hepatitis C and steatosis: a reappraisal. J Viral Hepat 2006;13(2):73-80.
15. Yoon EJ, Hu KQ. Hepatitis C virus (HCV) infection and hepatic steatosis. Int J Med Sci 2006;3(2):53-56. 16. Hwang SJ, Luo JC, Chu CW, et al. Hepatic steatosis in chronic hepatitis C virus infection: prevalence and clinical correlation. J Gastroenterol Hepatol 2001; 16: 190-195.
17. Li JF, Qu F, Zheng SJ, et al. Elevated plasma sphingomyelin (d18: 1/22: 0) is closely related to hepatic steatosis in patients with chronic hepatitis C virus infection. Eur J Clin Microbiol Infect Dis 2014; 33: 1725-1732.
18. Jian Wu Y, Shu Chen L, Gui Qiang W. Effects of fatty liver and related factors on the efficacy of combination antiviral therapy in patients with chronic hepatitis C. Liver Int 2006; 26: 166-172.
19. Hui JM, Kench JG, Chitturi S, et al. Long-term outcomes of cirrhosis in nonalcoholic steatohepatitis compared with hepatitis C. Hepatology 2003;38(2):420-427.
20. Neuschwander-Tetri BA. Hepatic lipotoxicity and the pathogenesis of nonalcoholic steatohepatitis:the central role of nontriglyceride fatty acid metabolism. Hepatology 2010;52:774-788.
21. Leite NC, Salles GF, Aruoja AL, et al. Prevalance and associated factors of nonalcoholic fatty liver disease in patients with type-2 diabetes mellitus. Liver Int 2009;29:113-119.
22. Peleg N, Issachar A, Arbib OS. Liver steatosis is a strong predictor of mortality and cancer in chronic hepatitis B regardless of viral load. JHEP Reports 2019 ;1:9–16.
23. Zhu D, Jiang J, Zhai X et al. Hepatitis B virus infection and risk of non-alcoholic fatty liver disease (NAFLD): a population-based cohort study. Liver Int. 2019;39(1):70–80. doi:10.1111/liv.13933.
24. Machado MV, Oliveira AG, Cortez-Pinto H. Hepatic steatosis in hepatitis B virus infected patients: meta-analysis of risk factors and comparison with hepatitis C infected patients. J Gastroenterol Hepatol. 2011;26(9):1361–1367.
25. Charatcharoenwitthaya P, Pongpaibul A, Kaosombatwattana U, et al. The prevalence of steatohepatitis in chronic hepatitis B patients and its impact on disease severity and treatment response. Liver Int. 2017;37(4):542–551.
26. Chan AW, Wong GL, Chan HY, et al. Concurrent fatty liver increases risk of hepatocellular carcinoma among patients with chronic hepatitis B. J Gastroenterol Hepatol. 2017;32(3):667–676.

The frequency and importance of combined non-alcoholic fatty liver disease in patients with chronic viral hepatitis

Year 2021, Volume: 14 Issue: 1, 77 - 86, 30.04.2021

Ferah Tuncel Aslıhan Alpaslan Duman

https://doi.org/10.26559/mersinsbd.883097

Abstract

Aim: The aim of the study is to determine the hepatosteatosis diagnosed as chronic viral hepatitis in liver biopsies and to reveal the relationship with the parameters in scoring systems and thus to predict the course of the disease. Method: Preparations of 110 cases diagnosed with chronic viral hepatitis in two different university hospitals were re-evaluated and scored based on modified histologic activity index and nonalcoholic fatty liver disease activity score (NAS) scoring system. The relationship between the parameters of these two scoring systems was examined. Results: Hepatosteatosis accompanies our chronic hepatitis C cases with a rate of 34.8% and chronic hepatitis B cases with a rate of 44.8%. As the steatosis score increases, the fibrosis scores of the cases also increase. Conclusion: Chronic viral hepatitis and nonalcoholic fatty liver disease (NAFLD), which are common chronic liver diseases, should not always be considered as separate entities. It should also be kept in mind that those can be occurred together. It will be important in terms of the course of disease that steatohepatosis accompanying chronic viral hepatitis cases should be stated in pathology reports.

Keywords

Chronic hepatitis, nonalcoholic fatty liver disease, fibrosis

Project Number

References

Kaynaklar 1. Liang J, Liu F, Wang F et al. A Noninvasive Score Model for Prediction of NASH in Patients with Chronic Hepatitis B and Nonalcoholic Fatty Liver Disease. Hindawi BioMed Research International 2017; 3: http://dx.doi.org/10.1155/2017/8793278.
2. Williams R. Global challenges in liver disease. Hepatology, 2006; 44 (3): 521–526.
3. Liu W, Baker RD, Bhatia T, Zhu L, Baker SS. Pathogenesis of nonalcoholic steatohepatitis, Cellular and Molecular Life Sciences. 2016; 73 (10): 1969–1987.
4. Minakari M, Molaei M, Shalmani HM, et al. Liver steatosis in patients with chronic hepatitis B infection: host and viral risk factors. European Journal of Gastroenterology and Hepatology. 2009; 21(5): 512–516.
5. Bondini S, Kallman J, Wheeler A, et al. Impact of nonalcoholic fatty liver disease on chronic hepatitis B. Liver International. 2007; 27 (5): 607–611.
6. Morales MA, Sendra C, Romero-Gomez M. Hepatitis B and NAFLD: Lives cossed. Annals of Hepatology.2017;16(2): 185-187.
7. Haga Y, Kanda T, Sasaki R, Nakamura M, Nakamoto S, Yokosuka O. Nonalcoholic fatty liver disease and hepatic cirrhosis: comparison with viral hepatitis-associated steatosis. World Journal of Gastroenterology.2015;21(16):12989-12995.
8. Yasui K, Harano Y, Mitsuyoshi H, et al. Steatosis and hepatic expression of genes regulating lipid metabolism in Japanese patients infected with hepatitis C virus. J Gastroenterol 2010; 45: 95-104.
9. Ishak K, Baptista A, Bianchi L, et al. Histological grading and staging of chronic hepatitis. J Hepatol 1995; 22: 696-699.
10. Kleiner DE, Brunt EM, Van Natta M, et al. Design and validation of a histological scoring sysytem for nonalcholic fatty liver disease. Hepatology. 2005;41:1313-1321.
11. Yilmaz B, Koklu S, Buyukbayram H, et al. Chronic hepatitis B associated with hepatic steatosis, insulin resistance, necroinflammation and fibrosis. Afri Health Sci. 2015;15(3):714-8. doi: http://dx.doi.org/10.4314/ahs.v15i3.3
12. Lavanchy D. Hepatitis B virus epidemiology, disease burden, treatment, and current and emerging prevention and control measures. J Viral Hepat 2004;11(2):97- 107.
13. Schiff E, Sorell M, Maddrey W. Disease of the Liver. 6th ed. Philadelphia: Lippincott-Williams and Wilkins; 1999.
14. Lonardo A, Loria P, Adinolfi LE, Carulli N, Ruggiero G. Hepatitis C and steatosis: a reappraisal. J Viral Hepat 2006;13(2):73-80.
15. Yoon EJ, Hu KQ. Hepatitis C virus (HCV) infection and hepatic steatosis. Int J Med Sci 2006;3(2):53-56. 16. Hwang SJ, Luo JC, Chu CW, et al. Hepatic steatosis in chronic hepatitis C virus infection: prevalence and clinical correlation. J Gastroenterol Hepatol 2001; 16: 190-195.
17. Li JF, Qu F, Zheng SJ, et al. Elevated plasma sphingomyelin (d18: 1/22: 0) is closely related to hepatic steatosis in patients with chronic hepatitis C virus infection. Eur J Clin Microbiol Infect Dis 2014; 33: 1725-1732.
18. Jian Wu Y, Shu Chen L, Gui Qiang W. Effects of fatty liver and related factors on the efficacy of combination antiviral therapy in patients with chronic hepatitis C. Liver Int 2006; 26: 166-172.
19. Hui JM, Kench JG, Chitturi S, et al. Long-term outcomes of cirrhosis in nonalcoholic steatohepatitis compared with hepatitis C. Hepatology 2003;38(2):420-427.
20. Neuschwander-Tetri BA. Hepatic lipotoxicity and the pathogenesis of nonalcoholic steatohepatitis:the central role of nontriglyceride fatty acid metabolism. Hepatology 2010;52:774-788.
21. Leite NC, Salles GF, Aruoja AL, et al. Prevalance and associated factors of nonalcoholic fatty liver disease in patients with type-2 diabetes mellitus. Liver Int 2009;29:113-119.
22. Peleg N, Issachar A, Arbib OS. Liver steatosis is a strong predictor of mortality and cancer in chronic hepatitis B regardless of viral load. JHEP Reports 2019 ;1:9–16.
23. Zhu D, Jiang J, Zhai X et al. Hepatitis B virus infection and risk of non-alcoholic fatty liver disease (NAFLD): a population-based cohort study. Liver Int. 2019;39(1):70–80. doi:10.1111/liv.13933.
24. Machado MV, Oliveira AG, Cortez-Pinto H. Hepatic steatosis in hepatitis B virus infected patients: meta-analysis of risk factors and comparison with hepatitis C infected patients. J Gastroenterol Hepatol. 2011;26(9):1361–1367.
25. Charatcharoenwitthaya P, Pongpaibul A, Kaosombatwattana U, et al. The prevalence of steatohepatitis in chronic hepatitis B patients and its impact on disease severity and treatment response. Liver Int. 2017;37(4):542–551.
26. Chan AW, Wong GL, Chan HY, et al. Concurrent fatty liver increases risk of hepatocellular carcinoma among patients with chronic hepatitis B. J Gastroenterol Hepatol. 2017;32(3):667–676.

There are 25 citations in total.

Details

Primary Language	Turkish
Subjects	Health Care Administration
Journal Section	Articles
Authors	Ferah Tuncel 0000-0001-6506-9461 Aslıhan Alpaslan Duman 0000-0002-3629-0906
Project Number	-
Publication Date	April 30, 2021
Submission Date	February 19, 2021
Acceptance Date	March 18, 2021
Published in Issue	Year 2021 Volume: 14 Issue: 1

Cite

APA	Tuncel, F., & Alpaslan Duman, A. (2021). Kronik viral hepatitli olgularda kombine non-alkolik yağlı karaciğer hastalığının sıklığı ve önemi. Mersin Üniversitesi Sağlık Bilimleri Dergisi, 14(1), 77-86. https://doi.org/10.26559/mersinsbd.883097
AMA	Tuncel F, Alpaslan Duman A. Kronik viral hepatitli olgularda kombine non-alkolik yağlı karaciğer hastalığının sıklığı ve önemi. Mersin Univ Saglık Bilim derg. April 2021;14(1):77-86. doi:10.26559/mersinsbd.883097
Chicago	Tuncel, Ferah, and Aslıhan Alpaslan Duman. “Kronik Viral Hepatitli Olgularda Kombine Non-Alkolik yağlı karaciğer hastalığının sıklığı Ve önemi”. Mersin Üniversitesi Sağlık Bilimleri Dergisi 14, no. 1 (April 2021): 77-86. https://doi.org/10.26559/mersinsbd.883097.
EndNote	Tuncel F, Alpaslan Duman A (April 1, 2021) Kronik viral hepatitli olgularda kombine non-alkolik yağlı karaciğer hastalığının sıklığı ve önemi. Mersin Üniversitesi Sağlık Bilimleri Dergisi 14 1 77–86.
IEEE	F. Tuncel and A. Alpaslan Duman, “Kronik viral hepatitli olgularda kombine non-alkolik yağlı karaciğer hastalığının sıklığı ve önemi”, Mersin Univ Saglık Bilim derg, vol. 14, no. 1, pp. 77–86, 2021, doi: 10.26559/mersinsbd.883097.
ISNAD	Tuncel, Ferah - Alpaslan Duman, Aslıhan. “Kronik Viral Hepatitli Olgularda Kombine Non-Alkolik yağlı karaciğer hastalığının sıklığı Ve önemi”. Mersin Üniversitesi Sağlık Bilimleri Dergisi 14/1 (April 2021), 77-86. https://doi.org/10.26559/mersinsbd.883097.
JAMA	Tuncel F, Alpaslan Duman A. Kronik viral hepatitli olgularda kombine non-alkolik yağlı karaciğer hastalığının sıklığı ve önemi. Mersin Univ Saglık Bilim derg. 2021;14:77–86.
MLA	Tuncel, Ferah and Aslıhan Alpaslan Duman. “Kronik Viral Hepatitli Olgularda Kombine Non-Alkolik yağlı karaciğer hastalığının sıklığı Ve önemi”. Mersin Üniversitesi Sağlık Bilimleri Dergisi, vol. 14, no. 1, 2021, pp. 77-86, doi:10.26559/mersinsbd.883097.
Vancouver	Tuncel F, Alpaslan Duman A. Kronik viral hepatitli olgularda kombine non-alkolik yağlı karaciğer hastalığının sıklığı ve önemi. Mersin Univ Saglık Bilim derg. 2021;14(1):77-86.

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