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Cited 6 time in webofscience Cited 6 time in scopus
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Predictive score for hepatocellular carcinoma after hepatitis B e antigen loss in patients treated with entecavir or tenofovir

Authors
Lim, Tae SeopLee, Hyun WoongLee, Jung IlKim, In HeeLee, Chang HunJang, Byoung KukChung, Woo JinYim, Hyung JoonSuh, Sang JunSeo, Yeon SeokLee, Han AhYu, Jung HwanLee, Jin-WooKim, Sang GyuneKim, Young SeokPark, Soo YoungTak, Won YoungKim, Soon SunCheong, Jae YounJeong, Soung WonJang, Jae YoungRou, Woo SunLee, Byung SeokKim, Seung UpKorean Transient Elastography Study Group
Issue Date
Oct-2020
Publisher
WILEY
Keywords
hepatitis B; hepatitis B e antigen; hepatocellular carcinoma; risk prediction
Citation
Journal of Viral Hepatitis, v.27, no.10, pp.1052 - 1060
Indexed
SCIE
SCOPUS
Journal Title
Journal of Viral Hepatitis
Volume
27
Number
10
Start Page
1052
End Page
1060
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/28007
DOI
10.1111/jvh.13316
ISSN
1352-0504
Abstract
The risk of developing hepatocellular carcinoma (HCC) after hepatitis B e antigen seroclearance (ESC) remains unclear. We established and validated a new risk prediction model for HCC development after ESC in patients with chronic hepatitis B (CHB) receiving antiviral therapy (AVT). Between 2006 and 2016, 769 patients (training cohort) and 1,061 patients (validation cohort) with CHB who experienced ESC during AVT using entecavir (ETV) or tenofovir disoproxil fumarate (TDF) were recruited. In the multivariate analysis, male sex (hazard ratio [HR] = 2.092; 95% confidence interval [CI] = 1.152-3.800), cirrhosis (HR = 5.141; 95% CI = 2.367-11.167) and fibrosis-4 index (FIB-4) of >3.25 (HR = 2.070; 95% CI = 1.184-3.620) were the independent risk factors for HCC development (all P < .05). Accordingly, a novel HCC-ESCAVT model was developed (1x[sex: male = 1, female = 0] + 3x(cirrhosis = 1, noncirrhosis = 0) + 1x(FIB-4: >3.25 = 1, <= 3.25 = 0). The cumulative risk for HCC development was significantly different among the risk groups based on the HCC-ESCAVT category (0-1, 2-4 and 5 for the low-, intermediate- and high-risk groups, respectively) (overall P < .001, log-rank test). The area under the receiver operating characteristic curve (AUC) for predicting HCC development 3, 5 and 10 years after ESC was 0.791, 0.771 and 0.790, respectively (all P < .05). The predictive value of the HCC-ESCAVT model was similar in the validation cohort (AUC = 0.802, 0.774 and 0.776 at 3, 5 and 10 years, respectively; all P < .05). Hence, we have developed and validated a new HCC-ESCAVT model for HCC development, which includes male sex, cirrhosis and FIB-4 of >3.25 as constituent variables.
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Seo, Yeon Seok
Anam Hospital (Department of Gastroenterology and Hepatology, Anam Hospital)
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