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As new evidence emerges, treatment strategies toward the functional cure of chronic hepatitis B are evolving. In 2019, a panel of national hepatologists published a Consensus Statement on the functional cure of chronic hepatitis B. Currently, an international group of hepatologists has been assembled to evaluate research since the publication of the original consensus, and to collaboratively develop the updated statements. The 2.0 Consensus was aimed to update the original consensus with the latest available studies, and provide a comprehensive overview of the current relevant scientific literatures regarding functional cure of hepatitis B, with a particular focus on issues that are not yet fully clarified. These cover the definition of functional cure of hepatitis B, its mechanisms and barriers, the effective strategies and treatment roadmap to achieve this endpoint, in particular new surrogate biomarkers used to measure efficacy or to predict response, and the appropriate approach to pursuing a functional cure in special populations, the development of emerging antivirals and immunomodulators with potential for curing hepatitis B. The statements are primarily intended to offer international guidance for clinicians in their practice to enhance the functional cure rate of chronic hepatitis B.
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Clin Mol Hepatol 2022;28(3):483-496. Published online March 2, 2022
Background/Aims Non-alcoholic fatty liver disease (NAFLD) is associated with the development of cardiovascular disease. While existing studies have examined cardiac remodeling in NAFLD, there has been less emphasis on the development of carotid atherosclerosis and stroke. We sought to conduct a meta-analysis to quantify the prevalence, risk factors, and degree of risk increment of carotid atherosclerosis and stroke in NAFLD.
Methods Embase and Medline were searched for articles relating to NAFLD, carotid atherosclerosis, and stroke. Proportional data was analysed using a generalized linear mixed model. Pairwise meta-analysis was conducted to obtain odds ratio or weighted mean difference for comparison between patients with and without NAFLD.
Results From pooled analysis of 30 studies involving 7,951 patients with NAFLD, 35.02% (95% confidence interval [CI], 27.36–43.53%) had carotid atherosclerosis with an odds ratio of 3.20 (95% CI, 2.37–4.32; P<0.0001). Pooled analysis of 25,839 patients with NAFLD found the prevalence of stroke to be 5.04% (95% CI, 2.74–9.09%) with an odds ratio of 1.88 (95% CI, 1.23–2.88; P=0.02) compared to non-NAFLD. The degree of steatosis assessed by ultrasonography in NAFLD was closely associated with risk of carotid atherosclerosis and stroke. Older age significantly increased the risk of developing carotid atherosclerosis, but not stroke in NAFLD.
Conclusions This meta-analysis shows that a stepwise increment of steatosis of NAFLD can significantly increase the risk of carotid atherosclerosis and stroke development in NAFLD. Patients more than a third sufferred from carotid atherosclerosis and routine assessment of carotid atherosclerosis is quintessential in NAFLD.
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Hepatic steatosis and advanced hepatic fibrosis are independent predictors of long‐term mortality in acute myocardial infarction YipHan Chin, Jieyu Lim, Gwyneth Kong, Cheng Han Ng, Rachel Goh, Mark Muthiah, Anurag Mehta, Bryan Chong, Chaoxing Lin, Kai En Chan, William Kong, Kian Keong Poh, Roger Foo, Ping Chai, Tiong‐Cheng Yeo, Adrian F. Low, Chi Hang Lee, Huay Cheem Tan, Mark Yan‐ Diabetes, Obesity and Metabolism.2023; 25(4): 1032. CrossRef
Examining the interim proposal for name change to steatotic liver disease in the US population Cheng Han Ng, Kai En Chan, Mark Muthiah, Caitlyn Tan, Phoebe Tay, Wen Hui Lim, Darren Jun Hao Tan, Clarissa Elysia Fu, Jie Ning Yong, Zhen Yu Wong, Benjamin Koh, Nicholas WS Chew, Nicholas Syn, Daniel Q. Huang, Yock Young Dan, Mohammad S. Siddiqui, Arun J Hepatology.2023; 77(5): 1712. CrossRef
The prognostic value of including non‐alcoholic fatty liver disease in the definition of metabolic syndrome Clarissa Elysia Fu, Jie Ning Yong, Cheng Han Ng, Benjamin Nah, Nicholas W. S. Chew, Yip Han Chin, Gwyneth Kong, Darren Jun Hao Tan, Wen Hui Lim, Lincoln Kai En Lim, Rebecca Wenling Zeng, Asim Shabbir, Eunice X. X. Tan, Daniel Q. Huang, Chin Meng Khoo, Moh Alimentary Pharmacology & Therapeutics.2023; 57(9): 979. CrossRef
Safety and tolerability of obeticholic acid in chronic liver disease: a pooled analysis of 1878 individuals Cheng Han Ng, Ansel Shao Pin Tang, Jieling Xiao, Zhen Yu Wong, Jie Ning Yong, Clarissa E. Fu, Rebecca W. Zeng, Caitlyn Tan, Gabriel Hong Zhe Wong, Margaret Teng, Douglas Chee, Darren Jun Hao Tan, Kai En Chan, Daniel Q. Huang, Nicholas W.S. Chew, Benjamin Hepatology Communications.2023; 7(3): e0005. CrossRef
Extrahepatic Outcomes of Nonalcoholic Fatty Liver Disease Angelo Armandi, Elisabetta Bugianesi Clinics in Liver Disease.2023; 27(2): 239. CrossRef
The global burden of metabolic disease: Data from 2000 to 2019 Nicholas W.S. Chew, Cheng Han Ng, Darren Jun Hao Tan, Gwyneth Kong, Chaoxing Lin, Yip Han Chin, Wen Hui Lim, Daniel Q. Huang, Jingxuan Quek, Clarissa Elysia Fu, Jieling Xiao, Nicholas Syn, Roger Foo, Chin Meng Khoo, Jiong-Wei Wang, Georgios K. Dimitriadis Cell Metabolism.2023; 35(3): 414. CrossRef
Risk Scores for Prediction of Major Cardiovascular Events in Non-Alcoholic Fatty Liver Disease: A No Man’s Land? Liliana Gheorghe, Roxana Nemteanu, Andreea Clim, Gina Eosefina Botnariu, Irina Iuliana Costache, Alina Plesa Life.2023; 13(4): 857. CrossRef
Nonalcoholic fatty liver disease and non-liver comorbidities Richie Manikat, Mindie H. Nguyen Clinical and Molecular Hepatology.2023; 29(Suppl): s86. CrossRef
Integrated bioinformatics and machine-learning screening for immune-related genes in diagnosing non-alcoholic fatty liver disease with ischemic stroke and RRS1 pan-cancer analysis Huayan Bao, Jianwen Li, Boyang Zhang, Ju Huang, Danke Su, Lidong Liu Frontiers in Immunology.2023;[Epub] CrossRef
General Public’s knowledge, awareness, and perception of Cardiometabolic diseases: data from a Singapore study population Vickram Vijay Anand, Rachel Sze Jen Goh, Benjamin Nah, Sky Wei Chee Koh, Jieyu Lim, Nicholas W. S. Neo, Jocelyn Chew, Yuan Ying Lee, Yip Han Chin, Bryan Chong, Gwyneth Kong, Bryan Tan, Zhiwen Low, Chin Meng Khoo, Lay Hoon Goh, Poay Huan Loh, Ping Chai, Ma Frontiers in Medicine.2023;[Epub] CrossRef
The regulatory role of metabolic organ-secreted factors in the nonalcoholic fatty liver disease and cardiovascular disease Li Qin, Junru Wu, Xuejing Sun, Xuewei Huang, Wei Huang, Chunyan Weng, Jingjing Cai Frontiers in Cardiovascular Medicine.2023;[Epub] CrossRef
Supplementation of Lactobacillus plantarum ATCC14917 mitigates non-alcoholic fatty liver disease in high-fat-diet-fed rats Xingjian Wen, Hejing Liu, Xiaoling Luo, Li Lui, Jiuyu Fan, Yajing Xing, Jia Wang, Xingfang Qiao, Na Li, Guixue Wang Frontiers in Microbiology.2023;[Epub] CrossRef
An international multidisciplinary consensus statement on MAFLD and the risk of CVD Xiao-Dong Zhou, Giovanni Targher, Christopher D. Byrne, Virend Somers, Seung Up Kim, C. Anwar A. Chahal, Vincent Wai-Sun Wong, Jingjing Cai, Michael D. Shapiro, Mohammed Eslam, Philippe Gabriel Steg, Ki-Chul Sung, Anoop Misra, Jian-Jun Li, Carlos Brotons, Hepatology International.2023; 17(4): 773. CrossRef
Editorial: The heart of NAFLD Nicholas W. S. Chew, Shankar Kannan, Bryan Chong, Yiphan Chin, Mark Muthiah Frontiers in Medicine.2023;[Epub] CrossRef
Ultrasound Score of Liver Steatosis Severity in the Diagnosis of Peripheral Arterial Atherosclerosis in Patients with Nonalcoholic Fatty Liver Disease A. S. Kuznetsova, A. I. Dolgushina, V. V. Pospelov, T. A. Sokolova, E. V. Lebedev, V. V. Genkel The Russian Archives of Internal Medicine.2023; 13(3): 196. CrossRef
MAFLD might be better in identifying subjects with sarcopenia or cardiovascular risk than NAFLD: A nationwide study Eugene Han, Ho Soo Chun, Yong‐ho Lee, Jae Seung Lee, Hye Won Lee, Beom Kyung Kim, Jun Yong Park, Do Young Kim, Byung‐Wan Lee, Eun Seok Kang, Bong‐Soo Cha, Sang Hoon Ahn, Seung Up Kim Journal of Gastroenterology and Hepatology.2023; 38(9): 1598. CrossRef
Nonalcoholic Fatty Liver Disease and Cardiovascular Disease: Clinical Evidence and a Mechanistic Review 飏 屈 Advances in Clinical Medicine.2023; 13(08): 12753. CrossRef
High-density lipoproteins and non-alcoholic fatty liver disease Menno Hoekstra, Miranda Van Eck Atherosclerosis Plus.2023; 53: 33. CrossRef
Hepatic Involvement across the Metabolic Syndrome Spectrum: Non-Invasive Assessment and Risk Prediction Using Machine Learning Adelaida Solomon, Călin Remus Cipăian, Mihai Octavian Negrea, Adrian Boicean, Romeo Mihaila, Corina Beca, Mirela Livia Popa, Sebastian Mihai Grama, Minodora Teodoru, Bogdan Neamtu Journal of Clinical Medicine.2023; 12(17): 5657. CrossRef
Association of fat-to-muscle ratio with non-alcoholic fatty liver disease: a single-centre retrospective study Fengqin Yan, Guqiao Nie, Nianli Zhou, Meng Zhang, Wen Peng BMJ Open.2023; 13(10): e072489. CrossRef
Lack of association between nonalcoholic fatty liver disease and intracerebral hemorrhage: A community-based cohort study Jianwei Wu, Jiahuan Guo, Anxin Wang, Yijun Zhang, Shouling Wu, Xingquan Zhao Journal of Clinical Neuroscience.2023; 118: 7. CrossRef
Ankle systolic pressure index in non-diabetic non-alcoholic fatty liver disease: A case-control study Said Taharboucht, Rachida Guermaz, Mansour Brouri, Lamia Bengherbia, Ahcene Chibane JMV-Journal de Médecine Vasculaire.2023; 48(5-6): 154. CrossRef
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Clinical Management of Non-alcoholic Steatohepatitis and the Role of the Cardiologist Carlos Millán-Rodríguez, Carlos Palacios Castelló Palacios Castelló, María de Regla Caballero-Valderrama, Gonzalo Barón Esquivias European Cardiology Review.2023;[Epub] CrossRef
Nonalcoholic fatty liver disease and cardiovascular diseases: A Mendelian randomization study Hexiang Peng, Siyue Wang, Mengying Wang, Ying Ye, Enci Xue, Xi Chen, Xueheng Wang, Meng Fan, Wenjing Gao, Xueying Qin, Yiqun Wu, Dafang Chen, Jin Li, Yonghua Hu, Li Wang, Tao Wu Metabolism.2022; 133: 155220. CrossRef
Does nonalcoholic fatty liver disease predispose patients to carotid arteriosclerosis and ischemic stroke? Qian Jin, Rui-Xu Yang, Jian-Gao Fan Clinical and Molecular Hepatology.2022; 28(3): 473. CrossRef
Living in the non‐alcoholic fatty liver disease silent epidemic: a qualitative systematic review of patients' perspectives Cheng Han Ng, Wen Hui Lim, Yip Han Chin, Jie Ning Yong, Rebecca Wenling Zeng, Kai En Chan, Darren Jun Hao Tan, Clarissa Elysia Fu, Ansel Shao Pin Tang, Lay Hoon Goh, Kamala Devi, Nicholas W. S. Chew, Lung‐Yi Loey Mak, Nobuharu Tamaki, Daniel Q. Huang, Maz Alimentary Pharmacology & Therapeutics.2022; 56(4): 570. CrossRef
Hypertension is prevalent in non-alcoholic fatty liver disease and increases all-cause and cardiovascular mortality Cheng Han Ng, Zhen Yu Wong, Nicholas W. S. Chew, Kai En Chan, Jieling Xiao, Nilofer Sayed, Wen Hui Lim, Darren Jun Hao Tan, Ryan Wai Keong Loke, Phoebe Wen Lin Tay, Jie Ning Yong, Gywneth Kong, Daniel Q. Huang, Jiong-Wei Wang, Mark Chan, Mayank Dalakoti, Frontiers in Cardiovascular Medicine.2022;[Epub] CrossRef
Statins decrease overall mortality and cancer related mortality but are underutilized in NAFLD: a longitudinal analysis of 12,538 individuals Cheng Han Ng, Margaret LP Teng, Nicholas WS Chew, Kai En Chan, Jie Ning Yong, Jingxuan Quek, Darren Jun Hao Tan, Wen Hui Lim, Gabriel Sheng Jie Lee, Jessica Wong, Apichat Kaewdech, Daniel Q Huang, Jiongwei Wang, Mark Y Chan, Mazen Noureddin, Mohammad Shad Expert Review of Gastroenterology & Hepatology.2022; 16(9): 895. CrossRef
Depression in non-alcoholic fatty liver disease is associated with an increased risk of complications and mortality Cheng Han Ng, Jieling Xiao, Nicholas W. S. Chew, Yip Han Chin, Kai En Chan, Jingxuan Quek, Wen Hui Lim, Darren Jun Hao Tan, Ryan Wai Keong Loke, Caitlyn Tan, Ansel Shao Pin Tang, Xin Lei Goh, Benjamin Nah, Nicholas Syn, Dan Yock Young, Nobuharu Tamaki, Da Frontiers in Medicine.2022;[Epub] CrossRef
Modulatory effect of camel milk on intestinal microbiota of mice with non-alcoholic fatty liver disease Shiqi Hao, Liang Ming, Yafei Li, Haodi Lv, Lin Li, Tuyatsetseg Jambal, Rimutu Ji Frontiers in Nutrition.2022;[Epub] CrossRef
High prevalence of non-alcoholic fatty liver disease in patients with a first episode of acute ischemic stroke. Impact on disability and death Lidia Canillas, Agnes Soriano-Varela, Ana Rodríguez-Campello, Eva Giralt-Steinhauer, Elisa Cuadrado-Godia, Teresa Broquetas Frontiers in Endocrinology.2022;[Epub] CrossRef
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