{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T09:58:05Z","timestamp":1781863085407,"version":"3.54.5"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:00:00Z","timestamp":1780963200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the association between comorbid Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and the risk of developing severe liver disease and cardiovascular disease (CVD) in patients with Chronic Hepatitis B (CHB).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>CHB Patients were continuously recruited from 2012 to 2022 using the electronic medical record system, and divided into CHB-no MASLD and CHB-MASLD groups. Follow-up continued until January 2024, aiming to compare differences of cumulative incidence between the two groups and to analyze associated risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      8,052 patients were included with a median follow-up of 3.9 years. Compared with CHB-no MASLD group, MASLD was independently associated with a 39% lower risk of severe liver disease (adjusted hazard ratio [aHR]=0.61, 95% confidence interval [CI] 0.49-0.76,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.001), with similar effects in cirrhosis (aHR=0.61, 95% CI 0.45-0.82,\n                      <jats:italic>p=<\/jats:italic>\n                      0.001) and hepatocellular carcinoma (HCC) (aHR=0.57, 95% CI 0.41-0.80,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.001). Stratified analyses indicated the protection effect was more significant in the HBsAg-positive group. Conversely, MASLD was associated with higher CVD risk (aHR=1.16, 95% CI 0.96-1.41,\n                      <jats:italic>p=<\/jats:italic>\n                      0.130), driven by coronary artery disease (aHR=1.91, 95% CI 1.34-2.74,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.001) and arrhythmia (aHR=1.44, 95% CI 1.00-2.08,\n                      <jats:italic>p=<\/jats:italic>\n                      0.053). These findings remained consistent after propensity score matching (PSM).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>MASLD may reduce the risk of severe liver disease through certain mechanisms, yet it also constitutes a risk factor for CVD, particularly among HBsAg-positive patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcimb.2026.1806927","type":"journal-article","created":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T05:44:15Z","timestamp":1780983855000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Metabolic dysfunction-associated steatotic liver disease in chronic hepatitis B patients: risks of severe liver disease and cardiovascular disease"],"prefix":"10.3389","volume":"16","author":[{"given":"Ningxin","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, The First Affiliated Hospital with Nanjing Medical University","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongwei","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The First Affiliated Hospital with Nanjing Medical University","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fei","family":"Lin","sequence":"additional","affiliation":[{"name":"Health Management Center, The First Affiliated Hospital with Nanjing Medical University","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haozhi","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Information Management, The First Affiliated Hospital with Nanjing Medical University","place":["Nanjing, China"]},{"name":"Jiangsu Clinical Medicine Research Institute","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dehong","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The First Affiliated Hospital with Nanjing Medical University","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiqiu","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The First Affiliated Hospital with Nanjing Medical University","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The First Affiliated Hospital with Nanjing Medical University","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiquan","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The First Affiliated Hospital with Nanjing Medical University","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengxiao","family":"Yu","sequence":"additional","affiliation":[{"name":"Health Management Center, The First Affiliated Hospital with Nanjing Medical University","place":["Nanjing, Jiangsu, China"]},{"name":"Department of Health Management, School of Public Health, Nanjing Medical University","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Longfeng","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The First Affiliated Hospital with Nanjing Medical University","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.13536","article-title":"Concurrent fatty liver increases risk of hepatocellular carcinoma among patients with chronic hepatitis B","volume":"32","author":"Chan","year":"2017","journal-title":"J Gastroenterol Hepatol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1186\/s12967-021-03210-9","article-title":"Increased burden of cardiovascular disease in people with liver disease: unequal geographical variations, risk factors and excess years of life lost","volume":"20","author":"Chang","year":"2022","journal-title":"J. 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