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When Metabolic Dysfunction-Associated Steatotic Liver Disease Meets Viral Hepatitis
Open accessAbstract
The interplay between Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and viral hepatitis, primarily hepatitis B virus (HBV) and hepatitis C virus (HCV), presents a complex challenge in managing chronic liver diseases. Recent epidemiological insights suggest an escalating prevalence of MASLD globally, attributed mainly to the obesity epidemic and associated metabolic disorders. Concurrently, chronic viral hepatitis remains a significant contributor to liver disease morbidity and mortality worldwide, despite advances in antiviral therapies. According to the World Health Organization (WHO) 2023 data, approximately 296 million people are living with chronic HBV infection (about 3.8% of the global population), and 58 million people with HCV infection (about 0.7%), together accounting for over 1.1 million deaths annually. The coexistence of MASLD and viral hepatitis presents a complex scenario in clinical outcomes, where the effects on liver health can vary. Although many studies highlight the potential for additive or synergistic worsening of liver conditions, leading to complications such as cirrhosis, liver failure, and HCC, the impact of HBV on MASLD is not consistent. Managing patients with dual MASLD and viral hepatitis is complex due to the interplay of metabolic and viral factors. Lifestyle modifications, including weight loss, dietary changes, and physical activity, are fundamental to MASLD management and help reduce fibrosis risk in viral hepatitis. This review examines the dual impact of MASLD and viral hepatitis on liver pathology and delineates shared pathophysiological mechanisms, including the influence on hepatic steatosis, inflammation, and fibrogenesis. It also discusses therapeutic strategies tailored to manage this comorbidity, emphasizing the need for an integrated care approach that addresses both metabolic dysfunctions and viral infection to optimize patient outcomes.
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“Thus, MASLD is now the leading cause of chronic liver disease and hence liver fibrosis (47–49).”
From Targeting macrophages in liver fibrosis (2026) · cites this paper as [47]
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Cited by
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Metadata
- Authors
- Hasanoglu, I., Rivero-Juárez, A., Özkaya Şahin, G., & ESCMID Study Group for Viral Hepatitis (ESGVH)
- Affiliations
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara Bilkent City Hospital, Ankara 06800, Türkiye
- Department of Infectious Diseases, Hospital Universitario Reina Sofia, Instituto Maimonides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba (UCO), 14071 Cordoba, Spain
- Clinical Microbiology, Infection Prevention and Control, Office for Medical Services, 22467 Lund, Sweden
- Venue
- Journal of Clinical Medicine
- Publisher
- MDPI AG
- Published
- 2025-05-14
- Volume
- 14
- Issue
- 10
- Pages
- 3422
- ISSN
- 2077-0383 (ISSN-L)
- PMC
- PMC12112634
- OpenAlex
- W4410368476
- Cited by
- 22
- References
- 39
- Citations by year
- 2026: 18 · 2025: 4
- FWCI
- 3.38
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Journal of Clinical Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- AYBU AVESIS (submittedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- Funders
- ESGVH
- Topics
- Health Sciences › Medicine › Hepatology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Hepatology › Hepatitis C virus research
- Health Sciences › Medicine › Epidemiology › Hepatitis B Virus Studies
- Keywords
- non-alcoholic fatty liver disease, viral hepatitis, hepatitis B virus, hepatitis C virus, comorbidities, hepatic steatosis, liver fibrosis, liver inflammation, liver cirrhosis, hepatocellular carcinoma, obesity, lifestyle modification, antiviral therapy, integrated care
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
