PAGE-B incorporating moderate HBV DNA levels predicts risk of HCC among patients entering into HBeAg-positive chronic hepatitis B.

HBeAg-positive chronic hepatitis B HBeAg-positive chronic infection hepatocellular carcinoma risk prediction model

Journal

Journal of hepatology
ISSN: 1600-0641
Titre abrégé: J Hepatol
Pays: Netherlands
ID NLM: 8503886

Informations de publication

Date de publication:
19 Sep 2023
Historique:
received: 26 02 2023
revised: 31 07 2023
accepted: 05 09 2023
pubmed: 22 9 2023
medline: 22 9 2023
entrez: 21 9 2023
Statut: aheadofprint

Résumé

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. 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. 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 log The newly established PAGED-B score may enable risk stratification for HCC at the time of transition into HBeAg-positive CHB. 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 log

Sections du résumé

BACKGROUND & AIMS OBJECTIVE
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 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 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 log
CONCLUSIONS 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 UNASSIGNED
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 log

Identifiants

DOI: 10.1016/j.jhep.2023.09.011 PMID: 37734683
pubmed: 37734683
pii: S0168-8278(23)05096-1
doi: 10.1016/j.jhep.2023.09.011
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2023 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

Auteurs

Ho Soo Chun (HS)

Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea; Department of Internal Medicine, Ewha Womans University Medical Center, Seoul, Korea.

George V Papatheodoridis (GV)

Department of Gastroenterology, Medical School of National and Kapodistrian University of Athens, General Hospital of Athens "Laiko", Athens, Greece.

Minjong Lee (M)

Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea; Department of Internal Medicine, Ewha Womans University Medical Center, Seoul, Korea. Electronic address: minjonglee2@naver.com.

Hye Ah Lee (HA)

Clinical Trial Center, Ewha Womans University Seoul Hospital, Seoul, Korea.

Yeong Hwa Kim (YH)

Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea.

Seo Hyun Kim (SH)

Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea.

Yun-Seo Oh (YS)

Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea.

Su Jin Park (SJ)

Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea.

Jihye Kim (J)

Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.

Han Ah Lee (HA)

Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea; Department of Internal Medicine, Ewha Womans University Medical Center, Seoul, Korea.

Hwi Young Kim (HY)

Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea; Department of Internal Medicine, Ewha Womans University Medical Center, Seoul, Korea.

Tae Hun Kim (TH)

Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea; Department of Internal Medicine, Ewha Womans University Medical Center, Seoul, Korea.

Eileen L Yoon (EL)

Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.

Dae Won Jun (DW)

Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.

Sang Hoon Ahn (SH)

Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea; Yonsei Liver Center, Severance Hospital, Seoul, Korea.

Vana Sypsa (V)

Department of Gastroenterology, Medical School of National and Kapodistrian University of Athens, General Hospital of Athens "Laiko", Athens, Greece.

Cihan Yurdaydin (C)

Department of Gastroenterology & Hepatology, Koc University Medical School, Istanbul, Turkey.

Pietro Lampertico (P)

Division of Gastroenterology and Hepatology, CRC "A. M. and A. Migliavacca" Center for Liver Disease, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

Jose Luis Calleja (JL)

Hospital U Puerta de Hierro, IDIPHIM CIBERehd, Madrid, Spain.

Harry LA Janssen (H)

Department of Gastroenterology & Hepatology, Erasmus MC University Medical Center, Rotterdam, Netherlands.

George N Dalekos (GN)

Department of Medicine and Research Laboratory of Internal Medicine, National Expertise Center of Greece in Autoimmune Liver Diseases, General University Hospital of Larissa, Larissa, Greece.

John Goulis (J)

4th Department of Internal Medicine, Αristotle University of Thessaloniki Medical School, Thessaloniki, Greece.

Thomas Berg (T)

Division of Hepatology, Department of Medicine II, Leipzig University Medical Center, Leipzig, Germany.

Maria Buti (M)

Hospital General Universitario Vall Hebron and Ciberehd, Barcelona, Spain.

Seung Up Kim (SU)

Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea; Yonsei Liver Center, Severance Hospital, Seoul, Korea. Electronic address: ksukorea@yuhs.ac.

Yoon Jun Kim (YJ)

Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea. Electronic address: yoonjun@snu.ac.kr.

Classifications MeSH