Abstract: Objective The aim of this study was to investigate the efficacy of entecavir in treatment of patients with chronic hepatitis B (CHB) and concomitant non-alcoholic fatty liver diseases (NAFLD). Methods 63 patients with CHB and 43 patients with CHB and NAFLD were recruited in this study between June 2019 and August 2021, and all patients received entecavir for anti-viral treatment for 12 months. The controlled attenuation parameter (CAP) of livers was detected byFibroscan-502. Serum HBV DNA loads were detected by fluorescence quantitative polymerase chain reaction. Serum alanine aminotransferase (ALT) levels were determined by automatic biochemical analyzer. Serum HBeAg and HBsAg were assayed by chemiluminescence method. Serum reactive oxide (ROS), adiponectin (ADPN) and tumor necrosis factor-α (TNF-α) levels were determined by ELISA. Results At the end of 6 month and 12 month anti-viral treatment, serum ALT normalization rates in patients with CHB were 69.8% and 92.1%, both significantly higher than 41.9% and 74.4% (P<0.05) in patients with CHB and NAFLD, while there were no significant differences respect to serum HBV DNA loss in the two groups (88.9% and 98.4% vs. 81.4% and 93.0%, respectively, P>0.05); at the end of 12 month treatment, serum ALT level in patients with CHB was (41.9±6.5)U/L, much lower than [(71.5±8.4)U/L, P<0.05] in patients with CHB and NAFLD, and the CAP of liver was (211.8±50.1)dB/m, much lower than [(288.0±13.4)dB/m, P<0.05] in patients with CHB and NAFLD; serum ROS and TNF-α levels in patients with CHB were (403.6±70.2)U/mL and (15.5±5.6)ng/L, both significantly lower than [(628.7±67.5)U/mL and (31.7±6.0)ng/L, respectively, P<0.05], while serum ADPN level was (17.7±1.2)ng/mL, much higher than [(11.5±1.8)ng/mL, P<0.05] in patients with CHB and NAFLD. Conclusion The existence of hepatic steatosis in patient with CHB and NAFLD might reduce the biochemical response to entecavir anti-viral therapy, which needs further investigation when the antiviral regimen is made in this setting.

Key words: Hepatitis B, Non-alcoholic fatty liver diseases, Entecavir, Controlled attenuation parameter, Therapy