The Relationship between Metabolic Factors and Hepatitis B Virus DNA Levels in Chronic Hepatitis B Virus Infection

OBJECTIVES: This study aimed to investigate whether metabolic and lifestyle factors were independently associated with serum levels of deoxyribonucleic acid of hepatitis B virus (HBV DNA), a valuable predictor for advanced liver diseases.
METHODS: Participants were hepatitis B virus (HBV) carriers in a university of Northern Taiwan. A total of 141 participants who had positive serum hepatitis B surface antigen, negative serum antibody to hepatitis C virus, and no liver cirrhosis received a structured questionnaire and underwent the anthropometric indices, serum HBV DNA levels and metabolic factors measurements. The odds ratios (ORs) and 95% confidence interval (CI) of high serum HBV DNA level (≥10000 copies/mL) were estimated by multiple logistic regression analyses.
RESULTS: As compared to overweight (body mass index (BMI) 23-24.9 kg/m2), obesity (BMI ≥25 kg/m2) (OR=3.84, 95% CI=1.38-10.7, P=0.010) and normal weight (BMI 18.5-22.9 kg/m2) (OR=5.27, 95% CI=1.49-18.6, P=0.010) were at significant risk of high serum HBV DNA levels after adjustment for age, gender, hepatitis B e antigen (HBeAg) serostatus, high alanine aminotransferase (ALT) level, and insulin resistance defined as the homeostasis model assessment of insulin resistance ≥2.5. This effect kept consistent even in stepwise analysis restricted to HBeAg seronegatives. Furthermore, insulin resistance and obesity had additive effects on high HBV DNA levels (OR=9.22, 95% CI=1.73-49.1, P=0.009) after controlling for age, gender, HBeAg serostatus, and high ALT level.
CONCLUSIONS: The V shape association that linking overweight with low HBV DNA levels suggests the potential modifiability of hepatitis B viral loads through metabolic factors. Further investigation is warranted for the causal temporality and early preventive strategies.