Hepatic Steatosis in People With Chronic Hepatitis B in Africa: Prevalence, Correlates, and Clinical Significance
Abstract
To address data gaps around metabolic liver disease in Africa, within the Hepatitis B in Africa Collaborative Network (HEPSANET), we evaluated participants with chronic hepatitis B virus infection (CHB) for steatotic liver disease (SLD) using transient elastography with controlled attenuation parameter (CAP). Using multivariable logistic regression, we identified sociodemographic, anthropometric, and clinical associations with SLD (CAP ≥ 248 dB/m), and evaluated whether SLD severity was independently associated with fibrosis. Short‐term impacts of SLD on mortality were also assessed with Cox proportional hazards analysis. We also evaluated the diagnostic performance of B‐mode ultrasound for SLD, with CAP as reference. Across 6 countries and 1601 participants (age range, 12–80 years; 39.5% female; 4% with diabetes; 11% unhealthy alcohol use; median body mass index, 24.4), 421 (26.3%) had SLD; 219 (13.7%) had severe steatosis (CAP ≥ 280 dB/m). Older age, male sex, overweight and obesity, and HIV‐negative status were associated with SLD. After adjusting for age, sex, HIV status, HBV treatment, and country, severe steatosis, but not mild and moderate forms (i.e., 248–279 dB/m), was associated with a 8.4% (95%, 1.9%–14.9%) increased probability of fibrosis. Over limited follow‐up (median 2.69 years) and small number of deaths, SLD was not associated with all‐cause or liver‐related mortality. B‐mode ultrasound had low sensitivity for SLD, overall or when severe, but specificity was 95%. In conclusion, SLD was common in people with CHB in Africa and its severe form was associated with liver fibrosis. These data support screening for metabolic comorbidities as part of HBV care and treatment in Africa.
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BibTeX
@article{chabala2026hepatic,
title = {{Hepatic Steatosis in People With Chronic Hepatitis B in Africa: Prevalence, Correlates, and Clinical Significance}},
author = {Freeman W. Chabala and Edford Sinkala and Alana T. Brennan and Amy Miskimon Goss and Lamin Bojang and Yusupha Samateh and Alexander Stockdale and Roger Sombié and Arouna Sessouma and Alice Nanelin Guingané and Juste Goungounga and Mohamed El-Kassas and Eman Marwan and Ibrahima Diallo and Abdoul Sow and Edith Okeke and Attah Okwute and Hans Prozesky and Zahiera Ismail and Mark Sonderup and C. Wendy Spearman and Philippa Matthews and Judicael Malick Tine and Maud Lemoine and Hailemichael Desalegn and Asgeir Johannessen and Michael J. Vinikoor},
journal = {Journal of Viral Hepatitis},
year = {2026},
month = oct,
doi = {10.1111/jvh.70241},
url = {https://hal.science/hal-05788530v1},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Hepatic Steatosis in People With Chronic Hepatitis B in Africa: Prevalence, Correlates, and Clinical Significance
AU - Freeman W. Chabala
AU - Edford Sinkala
AU - Alana T. Brennan
AU - Amy Miskimon Goss
AU - Lamin Bojang
AU - Yusupha Samateh
AU - Alexander Stockdale
AU - Roger Sombié
AU - Arouna Sessouma
AU - Alice Nanelin Guingané
AU - Juste Goungounga
AU - Mohamed El-Kassas
AU - Eman Marwan
AU - Ibrahima Diallo
AU - Abdoul Sow
AU - Edith Okeke
AU - Attah Okwute
AU - Hans Prozesky
AU - Zahiera Ismail
AU - Mark Sonderup
AU - C. Wendy Spearman
AU - Philippa Matthews
AU - Judicael Malick Tine
AU - Maud Lemoine
AU - Hailemichael Desalegn
AU - Asgeir Johannessen
AU - Michael J. Vinikoor
PY - 2026
DA - 2026/10/09
JO - Journal of Viral Hepatitis
DO - 10.1111/jvh.70241
UR - https://hal.science/hal-05788530v1
AB - To address data gaps around metabolic liver disease in Africa, within the Hepatitis B in Africa Collaborative Network (HEPSANET), we evaluated participants with chronic hepatitis B virus infection (CHB) for steatotic liver disease (SLD) using transient elastography with controlled attenuation parameter (CAP). Using multivariable logistic regression, we identified sociodemographic, anthropometric, and clinical associations with SLD (CAP ≥ 248 dB/m), and evaluated whether SLD severity was independently associated with fibrosis. Short‐term impacts of SLD on mortality were also assessed with Cox proportional hazards analysis. We also evaluated the diagnostic performance of B‐mode ultrasound for SLD, with CAP as reference. Across 6 countries and 1601 participants (age range, 12–80 years; 39.5% female; 4% with diabetes; 11% unhealthy alcohol use; median body mass index, 24.4), 421 (26.3%) had SLD; 219 (13.7%) had severe steatosis (CAP ≥ 280 dB/m). Older age, male sex, overweight and obesity, and HIV‐negative status were associated with SLD. After adjusting for age, sex, HIV status, HBV treatment, and country, severe steatosis, but not mild and moderate forms (i.e., 248–279 dB/m), was associated with a 8.4% (95%, 1.9%–14.9%) increased probability of fibrosis. Over limited follow‐up (median 2.69 years) and small number of deaths, SLD was not associated with all‐cause or liver‐related mortality. B‐mode ultrasound had low sensitivity for SLD, overall or when severe, but specificity was 95%. In conclusion, SLD was common in people with CHB in Africa and its severe form was associated with liver fibrosis. These data support screening for metabolic comorbidities as part of HBV care and treatment in Africa.
SN - 1352-0504
SN - 1365-2893
ER -