Abstract: Objective The aim of this study was to investigate the impact of antiviral therapy efficacy of entecavir in patients with chronic hepatitis B (CHB)and concomitant nonalcoholic fatty liver diseases (NAFLD).Methods 289 naïve serum HBeAg positive patients with CHB were enrolled in this study between January 2015 and January 2019, including 102 patients out of them with concomitant US-confirmed NAFLD. All patients received entecavir therapy and followed-up for 96 weeks. The biochemical, serologic and virological response were observed.Results The body mass index in patients with CHB and NAFLD was (26.1±2.7)kg/m², significantly higher than [(22.5±2.4)kg/m², P<0.05] in patients with CHB, serum uric acid l level was (405.1±125.8)μmol/L, significantly higher than [(324.6±96.8)μmol/L, P<0.05] in patients with CHB, serum total cholesterol level was (5.3±0.9 mmol/l, significantly higher than [(4.2±0.9)mmol/l, P<0.05] in patients with CHB, serum triglyceride level was (3.5±0.7)mmol/l, significantly higher than [(1.9±0.5) mmol/l, P<0.05] in patients with CHB, serum low density lipoprotein level was (3.4±1.0 mmol/l, significantly higher than [(2.3±0.8)mmol/l, P<0.05] in patients with CHB, and fasting blood glucose level was (5.9±1.5)mmol/l, significantly higher than [(4.6±0.6) mmol/l, P<0.05] in patients with CHB, while there were no significant differences respect to serum alanine aminotransferase levels (ALT, 250.8±110.5 U/L vs. 287.2±125.8 U/L), serum aspartate aminotransferase level (149.1±62.8 U/L vs. (168.7±70.8) U/L), serum high density lipoprotein level (1.2±0.5 mmol/l vs. 1.4±0.4mmol/l) and serum HBV DNA load (6.8±1.2 lg copies/ml vs. 6.9±1.1lg copies/ml) between the two groups (P>0.05); at the end of 48 week and 96 week treatment, serum ALT normalization rate in CHB patients with concomitant NAFLD were 69.6% and 81.4%, significantly lower than in patients with CHB(80.2% and 90.9%, respectively, P<0.05), while there were no significant differences respect to serum HBV DNA loss (79.4% and 87.3% vs. 84.0% and 90.9%, respectively), and serum HBeAg negative rates (7.8% and 7.8% vs. 5.3% and 5.9%) between the two groups (P>0.05).Conclusion The patients with CHB and concomitant NAFLD could poorly respond to entecavir antiviral therapy biochemically, and the impact on histological and long-term responses needs further investigation.

Key words: Chronic hepatitis B, Nonalcoholic fatty liver disease, Entecavir, Response