Risk scores to predict HCC and the benefits of antiviral therapy for CHB patients in gray zone of treatment guidelines
Backgrounds ALT ≥ 80 U/L and HBV DNA ≥ 2000 IU/ml are treatment criteria of APASL guidelines for chronic hepatitis B (CHB) patients. The need of antiviral therapy for patients in gray zone (ALT
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| Veröffentlicht in: | Hepatology international 2021-12, Vol.15 (6), p.1421-1430 |
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| creator | Teng, Wei Chang, Ting-Tsung Yang, Hwai-I Peng, Cheng-Yuan Su, Chien-Wei Su, Tung-Hung Hu, Tsung-Hui Yu, Ming-Lung Yang, Hung-Chih Wu, Jaw-Ching |
| description | Backgrounds
ALT ≥ 80 U/L and HBV DNA ≥ 2000 IU/ml are treatment criteria of APASL guidelines for chronic hepatitis B (CHB) patients. The need of antiviral therapy for patients in gray zone (ALT |
| doi_str_mv | 10.1007/s12072-021-10263-x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2594298324</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2594298324</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-82e75f1b35cbcd9db5d77aa51673d3b89e784f1d1ba057636d1b4c38791425753</originalsourceid><addsrcrecordid>eNp9kU9rFTEUxYNYbK1-ARcScONmbP5nZqlD9QkFQXQdMpM7z9R5yZhkSl8_vXm-WsFFV_dyz--cBA5Cryh5RwnRF5kyollDGG0oYYo3t0_QGe24aogU9OnDzvkpep7zNSFSKqqeoVMutKCa8TN089XnnziPMUHGJeIlgfNjwZu-xzY4XH4AHiDA5EvGcaq34m98svNBSXbZ4ykm3G8-4MUWD6FSPuBtsnt8FwMcLCWBLbsq4e3qHcw-QH6BTiY7Z3h5P8_R94-X3_pNc_Xl0-f-_VUzci1L0zLQcqIDl-Mwus4N0mltraRKc8eHtgPdiok6OlgiteKqbmLkre6oYFJLfo7eHnOXFH-tkIvZ-TzCPNsAcc2GyU6wruVMVPTNf-h1XFOovzNMEa0E54pUih2pMcWcE0xmSX5n095QYg6tmGMrprZi_rRibqvp9X30OuzAPVj-1lABfgRylcIW0r-3H4n9DVxIl7s</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2607643360</pqid></control><display><type>article</type><title>Risk scores to predict HCC and the benefits of antiviral therapy for CHB patients in gray zone of treatment guidelines</title><source>MEDLINE</source><source>SpringerLink</source><creator>Teng, Wei ; Chang, Ting-Tsung ; Yang, Hwai-I ; Peng, Cheng-Yuan ; Su, Chien-Wei ; Su, Tung-Hung ; Hu, Tsung-Hui ; Yu, Ming-Lung ; Yang, Hung-Chih ; Wu, Jaw-Ching</creator><creatorcontrib>Teng, Wei ; Chang, Ting-Tsung ; Yang, Hwai-I ; Peng, Cheng-Yuan ; Su, Chien-Wei ; Su, Tung-Hung ; Hu, Tsung-Hui ; Yu, Ming-Lung ; Yang, Hung-Chih ; Wu, Jaw-Ching</creatorcontrib><description>Backgrounds
ALT ≥ 80 U/L and HBV DNA ≥ 2000 IU/ml are treatment criteria of APASL guidelines for chronic hepatitis B (CHB) patients. The need of antiviral therapy for patients in gray zone (ALT < 80 U/L or HBV DNA < 2000 IU/ml) is controversial. This study aimed to develop a scoring system to predict hepatocellular carcinoma (HCC) and evaluate the benefit of antiviral therapy in these patients.
Methods
Seven hundred and forty-nine patients were analyzed. Significant variables were weighted to develop a scoring system for HCC prediction. The area under receiver operating curves (AUROC) were estimated and validated by REVEAL-HBV cohort (
n
= 3527).
Results
Older age (
p
< 0.001), male sex (
p
= 0.036), family history of HCC (
p
= 0.002) and HBV DNA ≥ 2000 IU/ml (
p
= 0.045) were independently associated with HCC. A 14-point risk score system predicts 3 and 5-years HCC risk to be 0.866 and 0.868 of AUROC, respectively in the derivation cohort; 0.821 and 0.820, in the REVEAL-HBV cohort. The cumulative HCC incidence was higher in the high risk (score ≥ 8) group both in derivation and validation cohorts (
p
< 0.001). Patients with antiviral therapy had lower HCC incidence compared to those without (
p
= 0.016). Of note, antiviral therapy significantly decreased HCC in the high risk group (
p
= 0.005), but not in the low risk group (
p
= 0.705).
Conclusions
A risk scoring system is established and validated. Of CHB patients in gray zone of APASL guidelines, those with risk scores ≥ 8 had higher risk of HCC, but the risk could be significantly reduced by antiviral therapy.</description><identifier>ISSN: 1936-0533</identifier><identifier>EISSN: 1936-0541</identifier><identifier>DOI: 10.1007/s12072-021-10263-x</identifier><identifier>PMID: 34741723</identifier><language>eng</language><publisher>New Delhi: Springer India</publisher><subject>Aged ; Antiviral agents ; Antiviral Agents - therapeutic use ; Antiviral drugs ; Carcinoma, Hepatocellular - drug therapy ; Carcinoma, Hepatocellular - epidemiology ; Colorectal Surgery ; Deoxyribonucleic acid ; Derivation ; DNA ; DNA, Viral ; Genetics ; Guidelines ; Hepatitis B ; Hepatitis B virus - genetics ; Hepatitis B, Chronic - drug therapy ; Hepatocellular carcinoma ; Hepatology ; Humans ; Interferon ; Liver cancer ; Liver Neoplasms - drug therapy ; Liver Neoplasms - epidemiology ; Male ; Medicine ; Medicine & Public Health ; Original Article ; Patients ; Risk ; Risk Factors ; Risk groups ; Surgery ; Therapy</subject><ispartof>Hepatology international, 2021-12, Vol.15 (6), p.1421-1430</ispartof><rights>Asian Pacific Association for the Study of the Liver 2021. corrected publication 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2021. Asian Pacific Association for the Study of the Liver.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-82e75f1b35cbcd9db5d77aa51673d3b89e784f1d1ba057636d1b4c38791425753</citedby><cites>FETCH-LOGICAL-c375t-82e75f1b35cbcd9db5d77aa51673d3b89e784f1d1ba057636d1b4c38791425753</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12072-021-10263-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12072-021-10263-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34741723$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Teng, Wei</creatorcontrib><creatorcontrib>Chang, Ting-Tsung</creatorcontrib><creatorcontrib>Yang, Hwai-I</creatorcontrib><creatorcontrib>Peng, Cheng-Yuan</creatorcontrib><creatorcontrib>Su, Chien-Wei</creatorcontrib><creatorcontrib>Su, Tung-Hung</creatorcontrib><creatorcontrib>Hu, Tsung-Hui</creatorcontrib><creatorcontrib>Yu, Ming-Lung</creatorcontrib><creatorcontrib>Yang, Hung-Chih</creatorcontrib><creatorcontrib>Wu, Jaw-Ching</creatorcontrib><title>Risk scores to predict HCC and the benefits of antiviral therapy for CHB patients in gray zone of treatment guidelines</title><title>Hepatology international</title><addtitle>Hepatol Int</addtitle><addtitle>Hepatol Int</addtitle><description>Backgrounds
ALT ≥ 80 U/L and HBV DNA ≥ 2000 IU/ml are treatment criteria of APASL guidelines for chronic hepatitis B (CHB) patients. The need of antiviral therapy for patients in gray zone (ALT < 80 U/L or HBV DNA < 2000 IU/ml) is controversial. This study aimed to develop a scoring system to predict hepatocellular carcinoma (HCC) and evaluate the benefit of antiviral therapy in these patients.
Methods
Seven hundred and forty-nine patients were analyzed. Significant variables were weighted to develop a scoring system for HCC prediction. The area under receiver operating curves (AUROC) were estimated and validated by REVEAL-HBV cohort (
n
= 3527).
Results
Older age (
p
< 0.001), male sex (
p
= 0.036), family history of HCC (
p
= 0.002) and HBV DNA ≥ 2000 IU/ml (
p
= 0.045) were independently associated with HCC. A 14-point risk score system predicts 3 and 5-years HCC risk to be 0.866 and 0.868 of AUROC, respectively in the derivation cohort; 0.821 and 0.820, in the REVEAL-HBV cohort. The cumulative HCC incidence was higher in the high risk (score ≥ 8) group both in derivation and validation cohorts (
p
< 0.001). Patients with antiviral therapy had lower HCC incidence compared to those without (
p
= 0.016). Of note, antiviral therapy significantly decreased HCC in the high risk group (
p
= 0.005), but not in the low risk group (
p
= 0.705).
Conclusions
A risk scoring system is established and validated. Of CHB patients in gray zone of APASL guidelines, those with risk scores ≥ 8 had higher risk of HCC, but the risk could be significantly reduced by antiviral therapy.</description><subject>Aged</subject><subject>Antiviral agents</subject><subject>Antiviral Agents - therapeutic use</subject><subject>Antiviral drugs</subject><subject>Carcinoma, Hepatocellular - drug therapy</subject><subject>Carcinoma, Hepatocellular - epidemiology</subject><subject>Colorectal Surgery</subject><subject>Deoxyribonucleic acid</subject><subject>Derivation</subject><subject>DNA</subject><subject>DNA, Viral</subject><subject>Genetics</subject><subject>Guidelines</subject><subject>Hepatitis B</subject><subject>Hepatitis B virus - genetics</subject><subject>Hepatitis B, Chronic - drug therapy</subject><subject>Hepatocellular carcinoma</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Interferon</subject><subject>Liver cancer</subject><subject>Liver Neoplasms - drug therapy</subject><subject>Liver Neoplasms - epidemiology</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Article</subject><subject>Patients</subject><subject>Risk</subject><subject>Risk Factors</subject><subject>Risk groups</subject><subject>Surgery</subject><subject>Therapy</subject><issn>1936-0533</issn><issn>1936-0541</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU9rFTEUxYNYbK1-ARcScONmbP5nZqlD9QkFQXQdMpM7z9R5yZhkSl8_vXm-WsFFV_dyz--cBA5Cryh5RwnRF5kyollDGG0oYYo3t0_QGe24aogU9OnDzvkpep7zNSFSKqqeoVMutKCa8TN089XnnziPMUHGJeIlgfNjwZu-xzY4XH4AHiDA5EvGcaq34m98svNBSXbZ4ykm3G8-4MUWD6FSPuBtsnt8FwMcLCWBLbsq4e3qHcw-QH6BTiY7Z3h5P8_R94-X3_pNc_Xl0-f-_VUzci1L0zLQcqIDl-Mwus4N0mltraRKc8eHtgPdiok6OlgiteKqbmLkre6oYFJLfo7eHnOXFH-tkIvZ-TzCPNsAcc2GyU6wruVMVPTNf-h1XFOovzNMEa0E54pUih2pMcWcE0xmSX5n095QYg6tmGMrprZi_rRibqvp9X30OuzAPVj-1lABfgRylcIW0r-3H4n9DVxIl7s</recordid><startdate>20211201</startdate><enddate>20211201</enddate><creator>Teng, Wei</creator><creator>Chang, Ting-Tsung</creator><creator>Yang, Hwai-I</creator><creator>Peng, Cheng-Yuan</creator><creator>Su, Chien-Wei</creator><creator>Su, Tung-Hung</creator><creator>Hu, Tsung-Hui</creator><creator>Yu, Ming-Lung</creator><creator>Yang, Hung-Chih</creator><creator>Wu, Jaw-Ching</creator><general>Springer India</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U7</scope><scope>C1K</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20211201</creationdate><title>Risk scores to predict HCC and the benefits of antiviral therapy for CHB patients in gray zone of treatment guidelines</title><author>Teng, Wei ; Chang, Ting-Tsung ; Yang, Hwai-I ; Peng, Cheng-Yuan ; Su, Chien-Wei ; Su, Tung-Hung ; Hu, Tsung-Hui ; Yu, Ming-Lung ; Yang, Hung-Chih ; Wu, Jaw-Ching</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-82e75f1b35cbcd9db5d77aa51673d3b89e784f1d1ba057636d1b4c38791425753</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Aged</topic><topic>Antiviral agents</topic><topic>Antiviral Agents - therapeutic use</topic><topic>Antiviral drugs</topic><topic>Carcinoma, Hepatocellular - drug therapy</topic><topic>Carcinoma, Hepatocellular - epidemiology</topic><topic>Colorectal Surgery</topic><topic>Deoxyribonucleic acid</topic><topic>Derivation</topic><topic>DNA</topic><topic>DNA, Viral</topic><topic>Genetics</topic><topic>Guidelines</topic><topic>Hepatitis B</topic><topic>Hepatitis B virus - genetics</topic><topic>Hepatitis B, Chronic - drug therapy</topic><topic>Hepatocellular carcinoma</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Interferon</topic><topic>Liver cancer</topic><topic>Liver Neoplasms - drug therapy</topic><topic>Liver Neoplasms - epidemiology</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Article</topic><topic>Patients</topic><topic>Risk</topic><topic>Risk Factors</topic><topic>Risk groups</topic><topic>Surgery</topic><topic>Therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Teng, Wei</creatorcontrib><creatorcontrib>Chang, Ting-Tsung</creatorcontrib><creatorcontrib>Yang, Hwai-I</creatorcontrib><creatorcontrib>Peng, Cheng-Yuan</creatorcontrib><creatorcontrib>Su, Chien-Wei</creatorcontrib><creatorcontrib>Su, Tung-Hung</creatorcontrib><creatorcontrib>Hu, Tsung-Hui</creatorcontrib><creatorcontrib>Yu, Ming-Lung</creatorcontrib><creatorcontrib>Yang, Hung-Chih</creatorcontrib><creatorcontrib>Wu, Jaw-Ching</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Hepatology international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Teng, Wei</au><au>Chang, Ting-Tsung</au><au>Yang, Hwai-I</au><au>Peng, Cheng-Yuan</au><au>Su, Chien-Wei</au><au>Su, Tung-Hung</au><au>Hu, Tsung-Hui</au><au>Yu, Ming-Lung</au><au>Yang, Hung-Chih</au><au>Wu, Jaw-Ching</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk scores to predict HCC and the benefits of antiviral therapy for CHB patients in gray zone of treatment guidelines</atitle><jtitle>Hepatology international</jtitle><stitle>Hepatol Int</stitle><addtitle>Hepatol Int</addtitle><date>2021-12-01</date><risdate>2021</risdate><volume>15</volume><issue>6</issue><spage>1421</spage><epage>1430</epage><pages>1421-1430</pages><issn>1936-0533</issn><eissn>1936-0541</eissn><abstract>Backgrounds
ALT ≥ 80 U/L and HBV DNA ≥ 2000 IU/ml are treatment criteria of APASL guidelines for chronic hepatitis B (CHB) patients. The need of antiviral therapy for patients in gray zone (ALT < 80 U/L or HBV DNA < 2000 IU/ml) is controversial. This study aimed to develop a scoring system to predict hepatocellular carcinoma (HCC) and evaluate the benefit of antiviral therapy in these patients.
Methods
Seven hundred and forty-nine patients were analyzed. Significant variables were weighted to develop a scoring system for HCC prediction. The area under receiver operating curves (AUROC) were estimated and validated by REVEAL-HBV cohort (
n
= 3527).
Results
Older age (
p
< 0.001), male sex (
p
= 0.036), family history of HCC (
p
= 0.002) and HBV DNA ≥ 2000 IU/ml (
p
= 0.045) were independently associated with HCC. A 14-point risk score system predicts 3 and 5-years HCC risk to be 0.866 and 0.868 of AUROC, respectively in the derivation cohort; 0.821 and 0.820, in the REVEAL-HBV cohort. The cumulative HCC incidence was higher in the high risk (score ≥ 8) group both in derivation and validation cohorts (
p
< 0.001). Patients with antiviral therapy had lower HCC incidence compared to those without (
p
= 0.016). Of note, antiviral therapy significantly decreased HCC in the high risk group (
p
= 0.005), but not in the low risk group (
p
= 0.705).
Conclusions
A risk scoring system is established and validated. Of CHB patients in gray zone of APASL guidelines, those with risk scores ≥ 8 had higher risk of HCC, but the risk could be significantly reduced by antiviral therapy.</abstract><cop>New Delhi</cop><pub>Springer India</pub><pmid>34741723</pmid><doi>10.1007/s12072-021-10263-x</doi><tpages>10</tpages></addata></record> |
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| language | eng |
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| subjects | Aged Antiviral agents Antiviral Agents - therapeutic use Antiviral drugs Carcinoma, Hepatocellular - drug therapy Carcinoma, Hepatocellular - epidemiology Colorectal Surgery Deoxyribonucleic acid Derivation DNA DNA, Viral Genetics Guidelines Hepatitis B Hepatitis B virus - genetics Hepatitis B, Chronic - drug therapy Hepatocellular carcinoma Hepatology Humans Interferon Liver cancer Liver Neoplasms - drug therapy Liver Neoplasms - epidemiology Male Medicine Medicine & Public Health Original Article Patients Risk Risk Factors Risk groups Surgery Therapy |
| title | Risk scores to predict HCC and the benefits of antiviral therapy for CHB patients in gray zone of treatment guidelines |
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