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PAGE-B incorporating moderate HBV DNA levels predicts risk of HCC among patients entering into HBeAg-positive chronic hepatitis B
- Title
- PAGE-B incorporating moderate HBV DNA levels predicts risk of HCC among patients entering into HBeAg-positive chronic hepatitis B
- Authors
- Chun, Ho Soo; Papatheodoridis, George V.; Lee, Minjong; Lee, Hye Ah; Kim, Yeong Hwa; Oh, Yun-Seo; Park, Su Jin; Kim, Jihye; Lee, Han Ah; Kim, Hwi Young; Kim, Tae Hun; Yoon, Eileen L.; Jun, Dae Won; Ahn, Sang Hoon; Sypsa, Vana; Yurdaydin, Cihan; Lampertico, Pietro; Calleja, Jose Luis; Janssen, Harry L. A.; Dalekos, George N.; Goulis, John; Berg, Thomas; Buti, Maria; Kim, Seung Up; Kim, Yoon Jun
- Ewha Authors
- 김태헌; 김휘영; 이민종; 이혜아; 전호수; 이한아
- SCOPUS Author ID
- 김태헌; 김휘영; 이민종; 이혜아; 전호수; 이한아
- Issue Date
- 2024
- Journal Title
- JOURNAL OF HEPATOLOGY
- ISSN
- 0168-8278
1600-0641
- Citation
- JOURNAL OF HEPATOLOGY vol. 80, no. 1
- Keywords
- HBeAg-positive chronic hepatitis B; HBeAg-positive chronic infection; hepatocellular carcinoma; risk prediction model
- Publisher
- ELSEVIER
- Indexed
- SCIE; SCOPUS
- Document Type
- Article
- Abstract
- Background & Aims: Recent studies reported that moderate HBV DNA levels are significantly associated with hepatocellular carcinoma (HCC) risk in hepatitis B e antigen (HBeAg)-positive, non-cirrhotic patients with chronic hepatitis B (CHB). We aimed to develop and validate a new risk score to predict HCC development using baseline moderate HBV DNA levels in patients entering into HBeAg-positive CHB from chronic infection. Methods: This multicenter cohort study recruited 3,585 HBeAg-positive, non-cirrhotic patients who started antiviral treatment with entecavir or tenofovir disoproxil fumarate at phase change into CHB from chronic infection in 23 tertiary university-affiliated hospitals of South Korea (2012-2020). A new HCC risk score (PAGED-B) was developed (training cohort, n = 2,367) based on multivariable Cox models. Internal validation using bootstrap sampling and external validation (validation cohort, n = 1,218) were performed. Results: Sixty (1.7%) patients developed HCC (median follow-up, 5.4 years). In the training cohort, age, gender, platelets, diabetes and moderate HBV DNA levels (5.00-7.99 log10 IU/ml) were independently associated with HCC development; the PAGED-B score (based on these five predictors) showed a time-dependent AUROC of 0.81 for the prediction of HCC development at 5 years. In the validation cohort, the AUROC of PAGED-B was 0.85, significantly higher than for other risk scores (PAGE-B, mPAGE-B, CAMD, and REAL-B). When stratified by the PAGED-B score, the HCC risk was significantly higher in highrisk patients than in low-risk patients (sub-distribution hazard ratio = 8.43 in the training and 11.59 in the validation cohorts, all p <0.001). Conclusions: The newly established PAGED-B score may enable risk stratification for HCC at the time of transition into HBeAgpositive CHB. (c) 2023 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
- DOI
- 10.1016/j.jhep.2023.09.011|http://dx.doi.org/10.1016/j.jhep.2023.09.011
- Appears in Collections:
- 의과대학 > 의학과 > Journal papers
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