|Title:||One-year Fibrosis-4 index helps identify minimal HCC risk in non-cirrhotic chronic hepatitis B patients with antiviral treatment||Authors:||Tseng, Tai Chung
Nguyen, Mindie H.
Peng, Cheng Yuan
Lim, Young Suk
Lai, Hsueh Chou
Trinh, Huy N.
|Keywords:||Entecavir | FIB-4 | HBV | Hepatocellular carcinoma | PAGE-B | Tenofovir;Entecavir; FIB-4; HBV; Hepatocellular carcinoma; PAGE-B; Tenofovir||Issue Date:||1-Feb-2021||Journal Volume:||15||Journal Issue:||1||Source:||Hepatology International||Abstract:||
© 2021, Asian Pacific Association for the Study of the Liver. Background and aims: Fibrosis-4 (FIB-4) index is a HCC predictor in chronic hepatitis B (CHB) patients. However, little is known about whether FIB-4 helps identify non-cirrhotic CHB patients with minimal HCC risk after prolonged nucleos(t)ide analogue (NA) therapy. Methods: A total of 1936 ethnically diverse, non-cirrhotic CHB patients were enrolled in this retrospective multi-national study. All patients received prolonged NA treatment, including entecavir and tenofovir disoproxil fumarate. We explored whether FIB-4 cutoff of 1.30, a marker indicative of mild fibrosis severity, could stratify HCC risks in these patients. Results: A total of 48 patients developed HCC after a mean follow-up of 6.98 years. FIB-4 level at 1 year after treatment (1-year FIB-4) was shown to be associated with HCC development and was superior to pre-treatment FIB-4 value. When patients were stratified by 1-year FIB-4 of 1.30, the high FIB-4 group was at an increased HCC risk compared to the low FIB-4 group, with a hazard ratio of 4.87 (95% confidence interval: 2.48–9.55). Multivariable analysis showed that sex and 1-year FIB-4 were independent predictors, with none of the 314 female patients with low 1-year FIB-4 developing HCC. Finally, 1-year FIB-4 of 1.30 consistently stratified HCC risks in patients with low PAGE-B score, a score composed of baseline age, sex and platelet count, and the annual incidence rate of HCC was 0.11% in those with PAGE-B < 10 + 1-year FIB-4 < 1.30. Conclusions: In non-cirrhotic CHB patients receiving prolonged NA therapy, 1-year FIB-4 < 1.30 is useful for identifying those with minimal HCC risk by combining with female sex or low PAGE-B score.
|URI:||https://scholars.lib.ntu.edu.tw/handle/123456789/552581||ISSN:||19360533||DOI:||10.1007/s12072-020-10124-z||metadata.dc.subject.other:||antivirus agent; entecavir; nucleoside analog; nucleotide derivative; tenofovir disoproxil; antivirus agent; adult; age; aged; Article; aspartate aminotransferase to platelet ratio index; cancer incidence; cancer risk; Caucasian; chronic hepatitis B; clinical article; digestive system disease assessment; disease association; disease severity; female; fibrosis 4 index; follow up; human; liver cell carcinoma; male; non cirrhotic chronic hepatitis B; non cirrhotic chronic hepatitis B; outcome assessment; PAGE B score; platelet count; priority journal; prognostic assessment; retrospective study; risk assessment; sex difference; treatment duration; virus load; complication; liver cell carcinoma; liver cirrhosis; liver tumor; Antiviral Agents; Carcinoma, Hepatocellular; Female; Hepatitis B, Chronic; Humans; Liver Cirrhosis; Liver Neoplasms; Retrospective Studies
|Appears in Collections:||臨床醫學研究所|
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.