Posttreatment FIB-4 score change predicts hepatocellular carcinoma in chronic hepatitis C patients: Findings from the Taiwan hepatitis C registry program.
Journal
Journal of the Formosan Medical Association = Taiwan yi zhi
ISSN
0929-6646
Date Issued
2025-02-28
Author(s)
Wang, Hung-Wei
Zeng, Yu-Syuan
Huang, Chung-Feng
Chen, Chi-Yi
Kuo, Hsing-Tao
Tseng, Kuo-Chih
Mo, Lein-Ray
Cheng, Pin-Nan
Tai, Chi-Ming
Hung, Chao-Hung
Lo, Ching-Chu
Lee, Pei-Lun
Yang, Chi-Chieh
Chen, Chun-Ting
Lin, Chun-Yen
Hsieh, Tsai-Yuan
Chong, Lee-Won
Lin, Chih-Lang
Hu, Jui-Ting
Yang, Sheng-Shun
Chuang, Wan-Long
Huang, Jee-Fu
Yeh, Ming-Lun
Dai, Chia-Yen
Huang, Yi-Hsiang
Lin, Han-Chieh
Bair, Ming-Jong
Wang, Szu-Jen
Huang, Chien-Wei
Tsai, Ming-Chang
Wang, Chia-Chi
Su, Wei-Wen
Lin, Chih-Wen
Lin, Chih-Lin
Chu, Cheng-Hsin
Yu, Ming-Lung
Peng, Cheng-Yuan
Abstract
Purpose: This study investigated whether Fibrosis-4 (FIB-4) score and its change can serve as predictors of hepatocellular carcinoma (HCC) development in patients with chronic hepatitis C (CHC) infection receiving direct-acting antivirals (DAAs). Methods: This study identified 9679 patients who completed DAA treatment and achieved sustained virologic response (SVR) from the Taiwan Nationwide Real-World HCV Registry Program, and their risk of HCC was analyzed. Results: Multivariable Cox regression analyses identified diabetes mellitus (DM), alpha-fetoprotein (AFP) level, and FIB-4 score as independent predictors of HCC in both Model 1 (baseline) and Model 2 (SVR). Change in FIB-4 score (△FIB-4) of < −0.9086 from baseline to SVR achievement was a significant predictor of HCC only in Model 2 (SVR). In Model 2 (SVR), DM (hazard ratio [HR]: 1.53, 95% confidence interval [CI]: 1.04–2.26, p = 0.033), FIB-4 score (≥3.25 vs. <3.25; HR: 2.40, 95% CI: 1.63–3.53, p < 0.001), △FIB-4 (greater reduction: <−0.9086 vs. smaller reduction: ≥−0.9086; HR: 1.85, 95% CI: 1.25–2.74, p = 0.002), and AFP level (≥20 vs. <20 ng/mL; HR: 16.40, 95% CI: 9.16–29.36, p < 0.001) were significant predictors of HCC. At 3 years, the cumulative HCC incidence was 10.67% in patients with an FIB-4 score of ≥3.25 upon achieving SVR and △FIB-4 of < −0.9086 and 1.72% in those with an FIB-4 score of <3.25 upon achieving SVR and △FIB-4 of ≥ −0.9086. Conclusions: Posttreatment FIB-4 score and its change from baseline can be used to stratify HCC risk in patients with CHC receiving DAAs.
Subjects
Chronic hepatitis C (CHC)
Direct-acting antivirals (DAAs)
FIB-4
Hepatocellular carcinoma (HCC)
SDGs
Type
journal article