studies

HEPATOLOGY, VOLUME 62, NUMBER 1 (SUPPL) AASLD ABSTRACTS 1287A
Disclosures:
Tetsuo Takehara - Grant/Research Support: Chugai Pharmaceutical Co., MSD
K.K., Bristol-Meyer Squibb, Mitsubishi Tanabe Pharma Corparation, Toray Industories
Inc. ; Speaking and Teaching: MSD K.K., Bristol-Meyer Squibb, Janssen
Pharmaceutical Companies
The following authors have nothing to disclose: Ayako Urabe, Naoki Hiramatsu,
Tsugiko Oze, Takayuki Yakushijin, Ryoko Yamada, Naoki Morishita, Yuki
Tahata, Yuichi Yoshida, Tomohide Tatsumi, Masahide Oshita, Akira Kaneko, Eiji
Mita, Masahiko Tsujii, Toshihiko Nagase, Hiroyuki Fukui, Kunio Suzuki, Atsuo
Inoue, Yasuharu Imai
2214
Concomitant Non-Alcoholic Fatty Liver Disease Drives
Progression of Overall Liver Disease More Than Chronic
Hepatitis B Alone in Chinese-Americans
Rouchelle D. dela Cruz 1 , Lan Sun Wang 1 , Anthony Ng 3 , Rene S.
Eng 3 , Lauren M. Eng 3 , Neil D. Theise 1,2 ; 1 Division of Digestive
Diseases, Mount Sinai Beth Israel Medical Center, New York, NY;
2 Department of Pathology, Mount Sinai Beth Israel Medical Center,
New York, NY; 3 Ng Medical Group, New York, NY
Introduction: Despite the proven efficacy of current antiviral
therapy for chronic hepatitis B (CHB), up to 20% of patients on
long term oral antiviral treatment who have complete HBV suppression
have persistently elevated serum alanine transferase
(ALT) levels. It has been previously shown that non-alcoholic
fatty liver disease (NAFLD) is a likely culprit. This phenomenon
will contribute to an increasingly large cohort of patients who
will develop NAFLD-related cirrhosis, decompensated liver disease,
and hepatocellular carcinoma. Asians may be especially
affected given endemic CHB and significant prevalence of metabolic
syndrome and NAFLD despite lower body mass index
and rate of obesity compared to other ethnicities. Methods:
Consecutive Chinese American patients from a single non-transplant
urban referral center (Mount Sinai Beth Israel Medical
Center, New York City) who underwent biopsies for CHB
between January 1, 2008 and Dec 31, 2012 were included in
this retrospective study. The biopsy specimens were reviewed,
regraded and restaged for NAFLD according to the scoring
system designed and validated by Kleiner, Brunt and the
Pathology Committee of the NASH Clinical Research Network.
Concomitant HBV grading and staging were also evaluated
using Scheuer’s classification for chronic hepatitis. Corresponding
clinical data was gathered. The patients were divided into
those with NAFLD (+) and without NAFLD (-) on pathology.
Pathology and clinical features were compared between the
two groups using the Wilcoxon rank-sum test. Results: Of the
148 patients, 41 were NAFLD+: 38 with steatosis, 18 with
steatohepatitis, 13 with steatofibrosis. Two of the patients with
steatofibrosis had no NAFLD activity but had significant fibrosis
attributable to NASH. There is a significantly higher combined
necroinflammatory activity (P=.00001) and overall combined
staging (P =.0015) in patients in the NAFLD+ group as compared
to the NAFLD- group. Clinically, alanine transaminase
(ALT, P=0.0084), body mass index (BMI, P