Recent HBV studies

Looks like it is still unclear how HBV and NAFLD influence each other. About 30% of HBV-infected people have NAFLD, not much higher than the general population. NAFLD seems to reduce HBV replication, but at the same time it reduced the efficacy of antiviral. Certain antiviral such as TAF might increase cholesterol levels, thus perhaps incidence of NAFLD and probably weight gain. Most importantly, it is still not clear whether NAFLD plus HBV had worse liver disease outcome, and whether NAFLD warrants HBV treatment and vise versa. I disagree with even the most simplified HBV guidelines that recommend deferring treatment of HBV patients with low viral load and elevated or normal ALT and look for other causes such as NAFLD or NASH/MASH. HBV is much easier to treat than NASH and thus anyone with both HBV and NASH should be treated for HBV infection while trying to resolve NASH.