Background and Aim: The coexistence of metabolic-associated fatty liver
disease (MAFLD) in the course of chronic hepatitis B virus infection increases liver-related morbidity. A positive correlation was found between
positive hepatitis B core antibody (anti-HBc) and the risk of cirrhosis and
hepatocellular carcinoma (HCC) in MAFLD. The relationship between anti-HBc positivity and MAFLD progression to fibrosis, cirrhosis, and liver-related outcomes was determined.
Materials and Methods: This is a retrospective study including 242 patients
with biopsy-proven MAFLD, 130 patients with clinically diagnosed MAFLD-related cirrhosis, and 62 patients with MAFLD-related or cryptogenic
HCC. Anti-HBc antibody results were compared with clinical outcomes.
Results: Anti-HBc positivity was associated with fibrosis severity
(p=0.005). Anti-HBc was positive in 19 (20.2%), 33 (25.8%), 53 (35.3%),
and 27 (43.5%) patients with F0–F1 fibrosis, F2–F3 fibrosis, cirrhosis (F4),
and HCC, respectively. Median steatosis score was grade 3 in anti-HBc positive patients and grade 2 in negative patients (p=0.07). Anti-HBc positivity
was not associated with significant fibrosis (≥F2), cirrhosis, and any liver
related complications including HCC.
Conclusion: Higher anti-HBc positivity was found in MAFLD patients
with advanced fibrosis and cirrhosis compared to patients with early stage
fibrosis. No relation was found between anti-HBc positivity and development of cirrhosis, HCC or other liver related complications.