Validation of hepatocellular carcinoma risk scores in Japanese chronic hepatitis B cohort receiving nucleot(s)ide analog.

Adenine / analogs & derivatives Adult Alanine Antiviral Agents / therapeutic use Asian People Carcinoma, Hepatocellular / epidemiology Cohort Studies Female Guanine / analogs & derivatives Hepatitis B, Chronic / complications Humans Japan / epidemiology Liver Neoplasms / epidemiology Male Middle Aged Nucleotides / therapeutic use Platelet Count Research Design Risk Tenofovir / therapeutic use Time Factors

chronic hepatitis B hepatocellular carcinoma nucleotide/nucleoside analog

Journal

Journal of gastroenterology and hepatology

ISSN: 1440-1746

Titre abrégé: J Gastroenterol Hepatol

Pays: Australia

ID NLM: 8607909

Informations de publication

Date de publication:
Sep 2020

Historique:

received: 01 12 2019

revised: 20 01 2020

accepted: 22 01 2020

pubmed: 25 1 2020

medline: 5 11 2020

entrez: 25 1 2020

Statut: ppublish

Résumé

The prediction of hepatocellular carcinoma (HCC) development during nucleotide/nucleoside analog (NA) therapy is clinically important in patients with chronic hepatitis B. Although several useful models for HCC prediction have been previously reported, their usefulness in the Japanese population is unclear. Therefore, this study examines the applicability of these models in Japanese patients. Four hundred forty-three patients with no history of HCC who were treated with entecavir, tenofovir alafenamide, or tenofovir disoproxil fumarate were enrolled. PAGE-B, modified-PAGE-B, and REACH-B scores were calculated, and subsequent HCC development was investigated. The mean follow-up duration was 5.1 years, and a total of 33 patients (7.4%) developed HCC during the follow-up period. Multivariate analysis revealed that old age (hazard ratio [HR] 1.05, 95% confidence interval [CI] 1.01-1.09, P = 0.011), male gender (HR 2.62, 95% CI 1.06-6.49, P = 0.037), and low platelet count (HR 0.83, 95% CI 0.77-0.91, P < 0.001) were independent predictors of HCC development. These factors are the same as the factors identified in the PAGE-B model. Time-dependent area under the receiver operating characteristic (AUROC) curve revealed that the AUROCs for 3 and 7 years of PAGE-B (AUROC: 0.786 and 0.744 at 3 and 7 years, respectively) were continuously higher than those of REACH-B (0.658 and 0.543) and modified PAGE-B AUROC (0.772 and 0.731). PAGE-B, which can easily identify high-risk cases, can be useful for predicting HCC development in Japanese patients treated with NA therapy.

Sections du résumé

BACKGROUND AND AIM OBJECTIVE

METHODS METHODS

Four hundred forty-three patients with no history of HCC who were treated with entecavir, tenofovir alafenamide, or tenofovir disoproxil fumarate were enrolled. PAGE-B, modified-PAGE-B, and REACH-B scores were calculated, and subsequent HCC development was investigated.

RESULTS RESULTS

The mean follow-up duration was 5.1 years, and a total of 33 patients (7.4%) developed HCC during the follow-up period. Multivariate analysis revealed that old age (hazard ratio [HR] 1.05, 95% confidence interval [CI] 1.01-1.09, P = 0.011), male gender (HR 2.62, 95% CI 1.06-6.49, P = 0.037), and low platelet count (HR 0.83, 95% CI 0.77-0.91, P < 0.001) were independent predictors of HCC development. These factors are the same as the factors identified in the PAGE-B model. Time-dependent area under the receiver operating characteristic (AUROC) curve revealed that the AUROCs for 3 and 7 years of PAGE-B (AUROC: 0.786 and 0.744 at 3 and 7 years, respectively) were continuously higher than those of REACH-B (0.658 and 0.543) and modified PAGE-B AUROC (0.772 and 0.731).

CONCLUSIONS CONCLUSIONS

PAGE-B, which can easily identify high-risk cases, can be useful for predicting HCC development in Japanese patients treated with NA therapy.

Identifiants

DOI: 10.1111/jgh.14990 PMID: 31975419

pubmed: 31975419

doi: 10.1111/jgh.14990

doi:

Substances chimiques

Antiviral Agents 0

Nucleotides 0

entecavir 5968Y6H45M

Guanine 5Z93L87A1R

Tenofovir 99YXE507IL

tenofovir alafenamide EL9943AG5J

Adenine JAC85A2161

Alanine OF5P57N2ZX

Types de publication

Journal Article Validation Study

Langues

eng

Sous-ensembles de citation

Pagination

1595-1601

Subventions

Organisme : Japan Agency for Medical Research and Development

ID : JP19fk0210025h0003

Informations de copyright

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