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Validation of risk prediction scores for hepatocellular carcinoma in patients with chronic hepatitis B treated with entecavir or tenofovir
Author(s) -
Chang Jin Won,
Lee Jae Seung,
Lee Hye Won,
Kim Beom Kyung,
Park Jun Yong,
Kim Do Young,
Ahn Sang Hoon,
Seo Yeon Seok,
Lee Han Ah,
Kim Mi Na,
Lee Yu Rim,
Hwang Seong Gyu,
Rim Kyu Sung,
Um Soon Ho,
Tak Won Young,
Kweon Young Oh,
Park Soo Young,
Kim Seung Up
Publication year - 2021
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/jvh.13411
Subject(s) - medicine , hepatocellular carcinoma , entecavir , cirrhosis , gastroenterology , hepatitis b , hazard ratio , chronic hepatitis , tenofovir , prothrombin time , hepatitis b virus , population , confidence interval , immunology , virus , environmental health , human immunodeficiency virus (hiv) , lamivudine
Several prediction scores for the early detection of hepatocellular carcinoma (HCC) are available. We validated the predictive accuracy of age, albumin, sex, liver cirrhosis (AASL), RESCUE‐B, PAGE‐B and modified PAGE‐B (mPAGE‐B) scores in chronic hepatitis B (CHB) patients treated with entecavir (ETV) or tenofovir disoproxil fumarate (TDF). Between 2007 and 2014, 3171 patients were recruited (1645, ETV; 1517, TDF). The predictive accuracy of each prediction score was assessed. The mean age of the study population (1977 men; 1194 women) was 48.8 years. Liver cirrhosis was present in 1040 (32.8%) patients. During follow‐up (median, 58.2 months), 280 (8.8%) patients developed HCC; these patients were significantly older; more likely to be male; had significantly higher proportions of liver cirrhosis, hypertension and diabetes; and had significantly higher values for the four risk scores than those who did not develop HCC (all P < .05). Older age (hazard ratio [HR] = 1.048), male sex (HR = 2.142), liver cirrhosis (HR = 3.144) and prolonged prothrombin time (HR = 2.589) were independently associated with an increased risk of HCC (all P < .05), whereas a higher platelet count (HR = 0.996) was independently associated with a decreased risk of HCC ( P < .05). The predictive accuracy of AASL score was the highest for 3‐ and 5‐year HCC predictions (areas under the curve [AUCs] = 0.818 and 0.816, respectively), followed by RESCUE‐B, PAGE‐B and mPAGE‐B scores (AUC = 0.780‐0.815 and 0.769‐0.814, respectively). In conclusion, four HCC prediction scores were assessed in Korean CHB patients treated with ETV or TDF. The AASL score showed the highest predictive accuracy.