WHAT IS ALREADY KNOWN ON THIS TOPIC

  • China has markedly reduced hepatitis B virus (HBV) and hepatitis C virus (HCV) prevalence through sustained prevention efforts but nationally representative data on liver disease severity (fibrosis) and coexisting steatosis among infected individuals remain limited.

  • WHAT THIS STUDY ADDS

  • By linking the 2020 China National Serological Survey with vibration-controlled transient elastography, this study provides nationally representative estimates of fibrosis and steatosis coexisting with HBV/HCV infection in China.

  • Among individuals aged 15–69 years, an estimated 6.08 million people with HBV infection and 0.48 million with HCV infection had ≥F2 fibrosis in China; steatosis was common in both cohorts (HBV 34.85%, HCV 42.43%).

  • HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY

  • Elimination strategies should move beyond infection control to proactive case-finding and strengthened linkage to care.

  • Integrated liver care is needed to address the substantial overlap between viral hepatitis and liver steatosis, alongside improved access to antiviral…