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Clin Liver Dis. 2014 Feb;18(1):165-78. doi: 10.1016/j.cld.2013.09.015.

The impact of obesity and metabolic syndrome on chronic hepatitis B and drug-induced liver disease.

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  • 1Department of Hepatogastroenterology, Université Pierre et Marie Curie, Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Inserm UMR_S 938, Paris 75013, France.


Steatosis and insulin resistance (IR) are no more frequent in chronic hepatitis B (CHB) than in the general population. Although experimental studies suggest that the HBx protein induces liver fat, human studies have shown that steatosis and IR are related to coexistent metabolic risk factors, thus epidemiologically linked rather than virally induced. Diabetes and obesity are associated with advanced fibrosis and increased risk of hepatocellular carcinoma in CHB. Despite abundant experimental data showing that fatty liver is more susceptible to liver injury, drug-induced liver disease seems no more frequent in NAFLD patients, except, possibly, a higher incidence but not severity of acetaminophen hepatotoxicity.

Copyright © 2014 Elsevier Inc. All rights reserved.


Chronic hepatitis B; Cirrhosis; Drug-induced liver injury; Fatty liver; Fibrosis; Hepatocellular carcinoma; Metabolic syndrome; Steatosis

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