REVIEW ARTICLE: The Relationship Between Nonalcoholic Fatty Liver Disease and Hepatitis B: Ameliorating or Aggravating? A Systematic Review

West Afr J Med. June 2025; 42(6): 494-505 PMID: 41252740

Abstract

Background/purpose: Chronic Hepatitis B is a global health challenge which has persisted despite universal vaccination against Hepatitis B. The relationship between hepatitis B virus infection and Non-alcoholic Fatty disease (NAFLD) remains unclear thus, a review was carried out to elucidate the nature of the relationship existing between them and the risk factors for this interrelation.

Data source and selection: The accepted guideline for a systematic review was followed. English language-based studies on hepatitis B and NAFLD in adult populations between 2010 -2021 were sourced from CINHAL, PubMed, Medline, Scopus, google scholar and ScienceDirect database.

Data extraction: Following the PICO format, studies which met the inclusion criteria were identified and selected on a Prisma chart. They were further assessed using the modified Newcastle-Ottawa score for the assessment of non-randomized studies.

Result: 11 out of 12,380 studies obtained from multiple databases were included in the review comprising of 128,566 controls and 5177 cases. The relationship between exposure to hepatitis B infection and NAFLD outcome was aggravating, ameliorating and non-existent in six, four and one study respectively. Risk factors for NAFLD identified include metabolic factors such as increased body mass index, hyperglycaemia, raised triglycerides, metabolic syndrome, hyperuricemia and the presence of hepatitis B HBx protein.

Conclusion: NAFLD is most likely to occur in HBV patients in the presence of host metabolic factors.