Serum fibrosis index-based risk score predicts hepatocellular carcinoma in untreated patients with chronic hepatitis B

Abstract

were responsible for the acquisition and analysis of data, had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. All authors were responsible for the interpretation of data, the drafting, and critical revision of the manuscript for important intellectual content.

Risk of hepatocellular carcinoma in untreated patients with chronic hepatitis B: Independent of HBeAg status?

“…Although baseline characteristics in this study 6 , such as old age, higher cirrhosis rates, and similar serum HBV DNA levels, showed a higher risk of HCC development compared with those in previous studies, 4,5 the risk of HCC development was quite lower than that in previous studies. The 5-year risk of HCC development was only 0.19% in the low-risk group and 1.12% in the high-risk group according to the Liang scores 6 . Even in the high-risk group, the HCC risk in this study was still lower than that mentioned in the previous studies.…”

“…In this study, 15,187 patients who had a median age of 51.9 years, had a median HBV DNA levels of 4.4 log 10 IU/mL, and of whom 5.4% had cirrhosis, only 1.2% developed HCC during a mean follow-up of 52 months. Although baseline characteristics in this study [ 6 ], such as old age, higher cirrhosis rates, and similar serum HBV DNA levels, showed a higher risk of HCC development compared with those in previous studies [ 4 , 5 ], the risk of HCC development was quite lower than that in previous studies. The 5-year risk of HCC development was only 0.19% in the low-risk group and 1.12% in the high-risk group according to the Liang scores [ 6 ].…”

“…5 In contrast to the results from the two aforementioned studies, Liang et al's study from this issue of Clinical and Molecular Hepatology reported a low risk of HCC development in a large cohort of untreated CHB patients, of whom 84% were HBeAg-negative, and suggested a prediction model for HCC development. 6 In this study, 15,187 patients who had a median age of 51.9 years, had a median HBV DNA levels of 4.4 log 10 IU/mL, and of whom 5.4% had cirrhosis, only 1.2% developed HCC during a mean follow-up of 52 months.…”

“…Although HBeAg status was not an independent factor for HCC development in a previous study [ 4 ], HCC incidence in HBeAg-negative CHB patients was still lower than in those who are HBeAg-positive [ 4 ]. The study by Liang et al [ 6 ] also reported a low incidence of HCC in a large cohort mainly composed of HBeAg-negative patients. Overall, in the three studies [ 4 - 6 ], the HCC incidence appears to be relatively lower in CHB patients who are HBeAg-negative than those who are HBeAg-positive.…”

“…Regarding the much lower incidence of HCC in the study by Liang et al [ 6 ] compared to the two previous studies, it will be helpful for readers to understand how HCC risk can be significantly different within HBeAg-negative status when HBV DNA levels and serum ALT levels (i.e., inactive, replicative, and mildly active phases) in CHB patients HBeAg-negative are taken into consideration. Although HBeAg status was not an independent factor for HCC development in a previous study [ 4 ], HCC incidence in HBeAg-negative CHB patients was still lower than in those who are HBeAg-positive [ 4 ].…”