TY - JOUR
T1 - Risk and risk score performance of hepatocellular carcinoma development in patients with hepatitis b surface antigen seroclearance
AU - Park, Yewan
AU - Lee, Jeong Hoon
AU - Sinn, Dong Hyun
AU - Park, Jun Yong
AU - Kim, Minseok Albert
AU - Kim, Yoon Jun
AU - Yoon, Jung Hwan
AU - Kim, Do Young
AU - Ahn, Sang Hoon
AU - Kang, Wonseok
AU - Gwak, Geum Youn
AU - Paik, Yong Han
AU - Choi, Moon Seok
AU - Lee, Joon Hyeok
AU - Koh, Kwang Cheol
AU - Paik, Seung Woon
N1 - Publisher Copyright:
© 2021 The Author(s).
PY - 2021/1/11
Y1 - 2021/1/11
N2 - 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 atrisk 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 amedian of 4.8 years of follow-up (range: 0.5-17.8 years),HCC developed in 23 patients (1.9%). TheHCC incidence ratewas 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/nocirrhosis, 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.
AB - 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 atrisk 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 amedian of 4.8 years of follow-up (range: 0.5-17.8 years),HCC developed in 23 patients (1.9%). TheHCC incidence ratewas 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/nocirrhosis, 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.
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U2 - 10.14309/ctg.0000000000000290
DO - 10.14309/ctg.0000000000000290
M3 - Article
C2 - 33433118
AN - SCOPUS:85099901790
VL - 12
JO - Clinical and Translational Gastroenterology
JF - Clinical and Translational Gastroenterology
SN - 2155-384X
IS - 1
M1 - e00290
ER -