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PAGE-B incorporating moderate HBV DNA levels predicts risk of HCC among patients entering into HBeAg-positive chronic hepatitis B
DC Field | Value | Language |
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dc.contributor.author | 김승업 | - |
dc.contributor.author | 안상훈 | - |
dc.date.accessioned | 2024-03-22T06:26:19Z | - |
dc.date.available | 2024-03-22T06:26:19Z | - |
dc.date.issued | 2024-01 | - |
dc.identifier.issn | 0168-8278 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/198548 | - |
dc.description.abstract | Background & aims: Recent studies reported that moderate HBV DNA levels are significantly associated with hepatocellular carcinoma (HCC) risk in hepatitis B e antigen (HBeAg)-positive, non-cirrhotic patients with chronic hepatitis B (CHB). We aimed to develop and validate a new risk score to predict HCC development using baseline moderate HBV DNA levels in patients entering into HBeAg-positive CHB from chronic infection. Methods: This multicenter cohort study recruited 3,585 HBeAg-positive, non-cirrhotic patients who started antiviral treatment with entecavir or tenofovir disoproxil fumarate at phase change into CHB from chronic infection in 23 tertiary university-affiliated hospitals of South Korea (2012-2020). A new HCC risk score (PAGED-B) was developed (training cohort, n = 2,367) based on multivariable Cox models. Internal validation using bootstrap sampling and external validation (validation cohort, n = 1,218) were performed. Results: Sixty (1.7%) patients developed HCC (median follow-up, 5.4 years). In the training cohort, age, gender, platelets, diabetes and moderate HBV DNA levels (5.00-7.99 log10 IU/ml) were independently associated with HCC development; the PAGED-B score (based on these five predictors) showed a time-dependent AUROC of 0.81 for the prediction of HCC development at 5 years. In the validation cohort, the AUROC of PAGED-B was 0.85, significantly higher than for other risk scores (PAGE-B, mPAGE-B, CAMD, and REAL-B). When stratified by the PAGED-B score, the HCC risk was significantly higher in high-risk patients than in low-risk patients (sub-distribution hazard ratio = 8.43 in the training and 11.59 in the validation cohorts, all p <0.001). Conclusions: The newly established PAGED-B score may enable risk stratification for HCC at the time of transition into HBeAg-positive CHB. Impact and implications: In this study, we developed and validated a new risk score to predict hepatocellular carcinoma (HCC) development in patients entering into hepatitis B e antigen (HBeAg)-positive chronic hepatitis B (CHB) from chronic infection. The newly established PAGED-B score, which included baseline moderate HBV DNA levels (5-8 log10 IU/ml), improved on the predictive performance of prior risk scores. Based on a patient's age, gender, diabetic status, platelet count, and moderate DNA levels (5-8 log10 IU/ml) at the phase change into CHB from chronic infection, the PAGED-B score represents a reliable and easily available risk score to predict HCC development during the first 5 years of antiviral treatment in HBeAg-positive patients entering into CHB. With a scoring range from 0 to 12 points, the PAGED-B score significantly differentiated the 5-year HCC risk: low <7 points and high ≥7 points. | - |
dc.description.statementOfResponsibility | restriction | - |
dc.language | English | - |
dc.publisher | Elsevier | - |
dc.relation.isPartOf | JOURNAL OF HEPATOLOGY | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.subject.MESH | Antiviral Agents / therapeutic use | - |
dc.subject.MESH | Carcinoma, Hepatocellular* / chemically induced | - |
dc.subject.MESH | Carcinoma, Hepatocellular* / etiology | - |
dc.subject.MESH | Child, Preschool | - |
dc.subject.MESH | Cohort Studies | - |
dc.subject.MESH | DNA, Viral | - |
dc.subject.MESH | Hepatitis B e Antigens | - |
dc.subject.MESH | Hepatitis B virus / genetics | - |
dc.subject.MESH | Hepatitis B, Chronic* / complications | - |
dc.subject.MESH | Hepatitis B, Chronic* / drug therapy | - |
dc.subject.MESH | Humans | - |
dc.subject.MESH | Liver Neoplasms* / chemically induced | - |
dc.subject.MESH | Liver Neoplasms* / etiology | - |
dc.subject.MESH | Persistent Infection | - |
dc.subject.MESH | Risk Factors | - |
dc.title | PAGE-B incorporating moderate HBV DNA levels predicts risk of HCC among patients entering into HBeAg-positive chronic hepatitis B | - |
dc.type | Article | - |
dc.contributor.college | College of Medicine (의과대학) | - |
dc.contributor.department | Dept. of Internal Medicine (내과학교실) | - |
dc.contributor.googleauthor | Ho Soo Chun | - |
dc.contributor.googleauthor | George V Papatheodoridis | - |
dc.contributor.googleauthor | Minjong Lee | - |
dc.contributor.googleauthor | Hye Ah Lee | - |
dc.contributor.googleauthor | Yeong Hwa Kim | - |
dc.contributor.googleauthor | Seo Hyun Kim | - |
dc.contributor.googleauthor | Yun-Seo Oh | - |
dc.contributor.googleauthor | Su Jin Park | - |
dc.contributor.googleauthor | Jihye Kim | - |
dc.contributor.googleauthor | Han Ah Lee | - |
dc.contributor.googleauthor | Hwi Young Kim | - |
dc.contributor.googleauthor | Tae Hun Kim | - |
dc.contributor.googleauthor | Eileen L Yoon | - |
dc.contributor.googleauthor | Dae Won Jun | - |
dc.contributor.googleauthor | Sang Hoon Ahn | - |
dc.contributor.googleauthor | Vana Sypsa | - |
dc.contributor.googleauthor | Cihan Yurdaydin | - |
dc.contributor.googleauthor | Pietro Lampertico | - |
dc.contributor.googleauthor | Jose Luis Calleja | - |
dc.contributor.googleauthor | Harry LA Janssen | - |
dc.contributor.googleauthor | George N Dalekos | - |
dc.contributor.googleauthor | John Goulis | - |
dc.contributor.googleauthor | Thomas Berg | - |
dc.contributor.googleauthor | Maria Buti | - |
dc.contributor.googleauthor | Seung Up Kim | - |
dc.contributor.googleauthor | Yoon Jun Kim | - |
dc.identifier.doi | 10.1016/j.jhep.2023.09.011 | - |
dc.contributor.localId | A00654 | - |
dc.contributor.localId | A02226 | - |
dc.relation.journalcode | J01441 | - |
dc.identifier.eissn | 1600-0641 | - |
dc.identifier.pmid | 37734683 | - |
dc.identifier.url | https://www.sciencedirect.com/science/article/pii/S0168827823050961 | - |
dc.subject.keyword | HBeAg-positive chronic hepatitis B | - |
dc.subject.keyword | HBeAg-positive chronic infection | - |
dc.subject.keyword | hepatocellular carcinoma | - |
dc.subject.keyword | risk prediction model | - |
dc.contributor.alternativeName | Kim, Seung Up | - |
dc.contributor.affiliatedAuthor | 김승업 | - |
dc.contributor.affiliatedAuthor | 안상훈 | - |
dc.citation.volume | 80 | - |
dc.citation.number | 1 | - |
dc.citation.startPage | 20 | - |
dc.citation.endPage | 30 | - |
dc.identifier.bibliographicCitation | JOURNAL OF HEPATOLOGY, Vol.80(1) : 20-30, 2024-01 | - |
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