Impact of antiviral therapy on risk prediction model for hepatocellular carcinoma development in patients with chronic hepatitis B

Abstract

Aim Risk prediction models for hepatocellular carcinoma (HCC) development are available. However, the influence of antiviral therapy (AVT) on these models in patients with chronic hepatitis B is unknown. Methods The dynamic changes in risk prediction models during AVT and the association between risk prediction model and the risk of chronic hepatitis B‐related HCC development were investigated. Between 2005 and 2017, 4917 patients with chronic hepatitis B (3361 noncirrhotic, 1556 cirrhotic) were recruited. Results The mean age of the study population was 49.3 years and 60.6% (n = 2980) of the patients were male. The mean Chinese University‐HCC (CU‐HCC) score was 12.7 at baseline in the overall study population, and decreased significantly (mean, 8.7) after 1 year of AVT (p < 0.001). The score was maintained throughout 5 years of AVT (mean, 8.4–8.8; p > 0.05). The proportion of high‐risk patients (CU‐HCC score ≥ 20) was 28.9% at baseline, and decreased significantly after 1 year of AVT (5.0%; p < 0.001), and remained stable through 5 years of AVT (2.2%–3.6%; p > 0.05). In addition to the score at baseline, the CU‐HCC score at 1 year of AVT independently predicted the risk of HCC development (hazard ratio = 1.072; p < 0.001), together with male gender and platelet count (all p < 0.05). Conclusions The CU‐HCC score significantly decreased at 1 year of AVT and was maintained thereafter. The CU‐HCC score after 1 year of AVT independently predicted the risk of HCC development in patients with chronic hepatitis B.

Non-cirrhotic hepatocellular carcinoma in chronic viral hepatitis: Current insights and advancements

“…Multiple risk prediction models have been developed for the study of HCC prevalence in HBV patients[ 96 ]. Some of these models include individual prediction model, Chinese University-HCC, Guide with Age, Gender, HBV DNA, Core Promoter Mutation and Cirrhosis-HCC, Risk Estimation for Hepatocellular Carcinoma in Chronic HBV and Nomogram-HCC[ 97 ]. Arends et al [ 98 ] noted that HCC incidence is lower in patients who have received antiviral therapy, even though it did not eliminate the risk: The reported 5-year cumulative incidence rate of NCHCC was 2.1%.…”

Validation of Hepatocellular Carcinoma Risk Prediction Models in Patients with Hepatitis B-Related Cirrhosis

“…Nevertheless, high-risk patients still have a higher risk of HCC development despite a significant reduction in the risk score than low-risk patients who experience no changes in the risk score. 43 There are some limitations to our study. First, this was a single-center retrospective study.…”

Diagnostic accuracy of hepatocellular carcinoma risk prediction models during antiviral therapy in chronic hepatitis B patients

“…We read with great interest the study by Chon et al 1 The authors demonstrated a hepatocellular carcinoma (HCC) prediction model of Chinese University-HCC (CU-HCC) score decreased significantly at 1 year after nucleoside/nucleotide analog (NA) therapy, but CU-HCC score at 1 year after NA therapy was an independent predictor of HCC development.…”

“…The other authors have no conflicts of interest to declare. Nobuharu Tamaki 1,2 Masayuki Kurosaki 1 Sakura Kirino 1 Namiki Izumi 1 1…”