Abstract: Objective The aim of this study was to observe the efficacy of combination of entecavir and polyene phosphatidylcholine (PPC) therapy in the treatment of patients with chronic hepatitit B (CHB) and nonalcoholic steatohepatitis (NASH). Methods 94 patients with CHB and non-alcoholic fatty liver disease (NAFLD) were recruited in our hospital between May 2021 and June 2023, including nonalcoholic fatter liver (NAFL) in 61 cases and NASH in 33 cases. All patients received enticavir (ETV) for antiviral treatment, and the patients with CHB and concomitant NASH received ETV and PPC combination therapy. The regimen lasted for six months. The routine serum detection was carried out for HOMA-IR calculation. Serum hyaluronic acid (HA), procollagen type III (PCIII), collagen type IV (IVC) and laminin (LN) levels were detected by ELISA. The Liver stiffness measurement (LSM) and controlled attenuation parameters (CAP) were detected by Fibroscan. Results At the end of six-month observation, serum ALT and AST levels in patients with CHB and NASH were (37.1±4.6)U/L and (34.5±3.8)U/L, both significantly lower than [(80.8±16.4)U/L and (62.7±12.8)U/L, respectively, P<0.05] at admission, and serum HBV DNA in all patients in the two groups became negative; there were no significant changes about the serum fat parameters and HOMA-IR (P>0.05) in the two groups; serum PCⅢ and HA levels in CHB patients with NASH were (109.5±13.7)ng/mL and (101.3±12.7)ng/mL, both significantly lower than [(136.4±17.1)ng/mL and (138.5±17.3)ng/mL, respectively, P<0.05] in CHB patients with NAFL; the CAP in CHB patients with NASH was (255.8±26.9)dB/m, much lower than [(269.4±30.1)dB/m, P<0.05] in CHB patients with NAFL. Conclusion The oral administration of PPC for auxiliary treatment at base of ETV antiviral therapy in patients with CHB and NASH could help improve biochemical parameters back to normal, and ameliorate hepatic steatosis.

Key words: Hepatitis B, Nonalcoholic steatohepatitis, Entecavir, Polyene phosphatidylcholine, Therapy