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Risk and Risk Score Performance of Hepatocellular Carcinoma Development in Patients With Hepatitis B Surface Antigen Seroclearance

Authors
 Yewan Park  ;  Jeong-Hoon Lee  ;  Dong Hyun Sinn  ;  Jun Yong Park  ;  Minseok Albert Kim  ;  Yoon Jun Kim  ;  Jung-Hwan Yoon  ;  Do Young Kim  ;  Sang Hoon Ahn  ;  Wonseok Kang  ;  Geum-Youn Gwak  ;  Yong-Han Paik  ;  Moon Seok Choi  ;  Joon Hyeok Lee  ;  Kwang Cheol Koh  ;  Seung Woon Paik 
Citation
 CLINICAL AND TRANSLATIONAL GASTROENTEROLOGY, Vol.12(1) : e00290, 2021-01 
Journal Title
CLINICAL AND TRANSLATIONAL GASTROENTEROLOGY
Issue Date
2021-01
Abstract
Introduction: Hepatocellular carcinoma (HCC) can develop among chronic hepatitis B patients after hepatitis B surface antigen (HBsAg) seroclearance. However, whether HCC risk after HBsAg seroclearance differs between antiviral therapy (AVT)-induced or spontaneous seroclearance cases and ways to identify at-risk populations remain unclear.

Methods: A retrospective cohort of 1,200 adult chronic hepatitis B patients who achieved HBsAg seroclearance (median age: 56 years; 824 men; 165 with cirrhosis; 216 AVT-induced cases) were analyzed. The risk of HCC after HBsAg seroclearance and the performance of 6 HCC prediction models were assessed.

Results: During a median of 4.8 years of follow-up (range: 0.5-17.8 years), HCC developed in 23 patients (1.9%). The HCC incidence rate was higher in the AVT-induced cases than that in the spontaneous cases (3.9% vs 0.9% at 5 years). AVT and cirrhosis were independent factors associated with HCC, with HCC incidence rates of 0.5%, 1.2%, 4.0%, and 10.5% at 5 years for spontaneous/no-cirrhosis, AVT-induced/no-cirrhosis, spontaneous/cirrhosis, and AVT-induced/cirrhosis patients, respectively. Among the 6 predictive HCC models tested, Chinese University-HCC score (0.82) showed the highest C-statistics, which was followed by guide with age, gender, HBV DNA, core promoter mutations and cirrhosis (0.81).

Discussion: AVT-induced HBsAg seroclearance was associated with higher HCC risk, especially for patients with cirrhosis, indicating that they need careful monitoring for HCC risk. The HCC risk models were able to stratify the HCC risk in patients with HBsAg seroclearance.
Files in This Item:
T202100482.pdf Download
DOI
10.14309/ctg.0000000000000290
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Young(김도영)
Park, Jun Yong(박준용) ORCID logo https://orcid.org/0000-0001-6324-2224
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/182137
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