1. Non-invasive tests for liver disease severity and the hepatocellular carcinoma risk in chronic hepatitis B patients with low-level viremia.
- Author
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Paik N, Sinn DH, Lee JH, Oh IS, Kim JH, Kang W, Gwak GY, Paik YH, Choi MS, Lee JH, Koh KC, and Paik SW
- Subjects
- Adult, Age Factors, Aspartate Aminotransferases blood, Biomarkers blood, Carcinoma, Hepatocellular diagnosis, Carcinoma, Hepatocellular epidemiology, DNA, Viral blood, DNA, Viral genetics, Disease Progression, Female, Hepacivirus genetics, Hepatitis B, Chronic blood, Hepatitis B, Chronic epidemiology, Hepatitis B, Chronic virology, Humans, Incidence, Liver Cirrhosis blood, Liver Cirrhosis epidemiology, Liver Cirrhosis virology, Liver Neoplasms diagnosis, Liver Neoplasms epidemiology, Male, Middle Aged, Platelet Count, Predictive Value of Tests, Prognosis, Reproducibility of Results, Retrospective Studies, Risk Assessment, Risk Factors, Seoul epidemiology, Severity of Illness Index, Time Factors, Ultrasonography, Viral Load, Viremia virology, Carcinoma, Hepatocellular virology, Hepacivirus pathogenicity, Hepatitis B, Chronic diagnosis, Liver Cirrhosis diagnosis, Liver Function Tests, Liver Neoplasms virology, Viremia diagnosis
- Abstract
Background & Aims: We tested whether non-invasive tests for liver disease severity can stratify hepatocellular carcinoma (HCC) risk in chronic hepatitis B virus (HBV)-infected patients showing low-level viremia (LLV, HBV DNA <2000 IU/mL)., Methods: A retrospective cohort of 1006 chronic hepatitis B patients showing persistently LLV, defined by at least two consecutive assessments in the year before enrolment, was assessed for HCC development. Two non-invasive serum biomarkers, the aspartate aminotransferase to platelet ratio index (APRI) and the Fibrosis-4 (FIB-4), were tested. Cirrhosis was defined with ultrasonography., Results: During a median 5.1 years of follow-up, HCC developed in 36 patients. HCC incidence rate at 5 years was significantly higher for cirrhotic patients (19/139, 13.7%), but was not null for non-cirrhotic patients (17/867, 2.0%, P<.001). APRI at a cut-off of 0.5 was more specific but less sensitive for HCC development, and FIB-4 at a cut-off of 1.45 was more sensitive but less specific. When both APRI and FIB-4 were used to group patients, the 5-year cumulative HCC incidence rate was 13.9%, 1.4% and 1.2% for both high, any high, and both low APRI and FIB-4 score among all patients (n=1006, P<.001), respectively, and was 11.4%, 1.5% and 0.4% in the same respective order among non-cirrhotic patients (n=867, P<.001)., Conclusions: The combined use of two non-invasive serum biomarkers (APRI and FIB-4) could stratify HCC risk for chronic HBV-infected patients with LLV., (© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
- Published
- 2018
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