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Predictive score for hepatocellular carcinoma after hepatitis B e antigen loss in patients treated with entecavir or tenofovir

 Tae Seop Lim  ;  Hyun Woong Lee  ;  Jung Il Lee  ;  In Hee Kim  ;  Chang Hun Lee  ;  Byoung Kuk Jang  ;  Woo Jin Chung  ;  Hyung Joon Yim  ;  Sang Jun Suh  ;  Yeon Seok Seo  ;  Han Ah Lee  ;  Jung Hwan Yu  ;  Jin-Woo Lee  ;  Sang Gyune Kim  ;  Young Seok Kim  ;  Soo Young Park  ;  Won Young Tak  ;  Soon Sun Kim  ;  Jae Youn Cheong  ;  Soung Won Jeong  ;  Jae Young Jang  ;  Woo Sun Rou  ;  Byung Seok Lee  ;  Seung Up Kim  ;  Korean Transient Elastography Study Group 
 JOURNAL OF VIRAL HEPATITIS, Vol.27(10) : 1052-1060, 2020-10 
Journal Title
Issue Date
hepatitis B ; hepatitis B e antigen ; hepatocellular carcinoma ; risk prediction
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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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Lee, Jung Il(이정일) ORCID logo https://orcid.org/0000-0002-0142-1398
Lee, Hyun Woong(이현웅) ORCID logo https://orcid.org/0000-0002-6958-3035
Lim, Tae Seop(임태섭) ORCID logo https://orcid.org/0000-0002-4578-8685
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