![Photo courtesy of NTU Hospital Feb. 12, 2025](https://imgcdn.cna.com.tw/Eng/WebEngPhotos/800/2025/20250212/2000x1333_092956876931.jpg)
Taipei, Feb. 12 (CNA) Research conducted by a local hospital has found that hepatitis B patients with a simple fatty liver have a lower mortality risk than those without, suggesting that excessive fat in the liver could play a protective role against hepatitis B by potentially inhibiting viral replication.
"Hepatitis B currently affects over 300 million people worldwide and is a leading cause of liver cirrhosis and liver cancer," said Su Tung-Hung (蘇東弘), a clinical assistant professor in National Taiwan University Hospital's (NTUH) Department of Internal Medicine, at a news conference at NTUH on Wednesday.
Su added that an estimated 2 million people in Taiwan are carriers of chronic hepatitis B, a viral liver disease caused by the hepatitis B virus, which can be transmitted through blood, bodily fluids, or mother-to-child transmission.
While acute hepatitis B has no specific treatment and chronic hepatitis B can be managed with oral antiviral medications, there is still "no highly effective treatment available" for hepatitis B in general, said Huang Shang-chin (黃上秦), an attending physician at NTUH Bei-Hu Branch's Department of Gastroenterology and Hepatology.
Among chronic hepatitis B carriers in Taiwan, many also suffer from metabolic dysfunction, including diabetes, hypertension, and obesity, as well as steatotic (fatty) liver disease, due to dietary habits and lifestyles becoming increasingly Westernized in recent years, Su noted.
As the long-term impact of metabolic dysfunction and steatotic liver disease on chronic hepatitis B patients is "still not fully understood," Su said, the NTUH hepatitis research team conducted a study using long-term monitoring data collected by the hospital from 2006 to 2021, analyzing over 10,000 hepatitis B patients.
The study, published in the Journal of Hepatology last December, found that chronic hepatitis B patients with metabolic dysfunction had a significantly higher all-cause mortality rate, with the risk increasing as the number of metabolic disorders increased, said Su, who together with Huang was a member of the research team.
Patients with three or more metabolic dysfunctions faced more than double the all-cause mortality risk compared to those without any metabolic dysfunctions, Su added.
He also noted that among various metabolic dysfunctions, diabetes poses the greatest threat to hepatitis B patients, with those having HbA1c (glycated hemoglobin) levels exceeding 8 percent -- indicating more severe diabetes -- facing a liver disease-related mortality risk four times higher than those with levels below 6 percent.
An unexpected finding in the study was that hepatitis B patients with only simple steatotic liver disease -- without additional metabolic dysfunctions -- had an approximately 50 percent lower all-cause mortality risk compared to hepatitis B patients who had neither steatotic liver disease nor cardiometabolic risk factors, Su said.
"These [excessive] fats may have an inhibitory effect on the replication of the hepatitis B virus," Su added.
Asked by CNA if deliberately inducing simple steatotic liver in patients could be a potential strategy to combat hepatitis B, Huang said that "is not easy to do," explaining that most cases of steatotic liver are accompanied by metabolic syndrome.
"It is impossible for us to clinically control for a condition where a patient develops simple steatotic liver without metabolic dysfunctions," he noted.
However, with further experiments and research exploring why simple steatotic liver can suppress or even clear the hepatitis B virus, researchers may be able to identify the underlying mechanisms, Huang said.
"If we can pinpoint those mechanisms, there is potential to develop targeted medicines based on them," he added.
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