Comparative performance of risk prediction models for hepatitis B-related hepatocellular carcinoma in the United States

Kim, Hyun-seok; Xin, Yu; Kramer, Jennifer R.; Thrift, Aaron P.; Richardson, Pete; Hsu, Yao‐Chun; Flores, Avegail; El–Serag, Hashem B.; Kanwal, Fasiha

doi:10.1016/j.jhep.2021.09.009

Cited by 27 publications

(14 citation statements)

References 22 publications

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“…The accuracy of AFP previously reported in other countries. [38][39][40][41] These results support the hypothesis that metabolic, genetic, and/or epigenetic factors associated with carcinogenesis may have accumulated in the background liver during HBV infection as the risk of HCC development persists even in patients who have achieved prolonged complete viral suppression. 42 It is also important to understand that current NA therapy does not fully eliminate the risk of developing HCC.…”

Section: Discussionsupporting

confidence: 73%

Risk factors for hepatocellular carcinoma at baseline and 1 year after initiation of nucleos(t)ide analog therapy for chronic hepatitis B

Kaneko

Kurosaki

Mashiba

et al. 2022

Journal of Medical Virology

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Nucleos(t)ide analogs (NAs) cannot completely suppress the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB). This study aimed to identify the risk factors for HCC development in naïve CHB patients treated with current NA. Patients receiving NA (n = 905) were recruited retrospectively from the 17 hospitals of the Japanese Red Cross Liver Study Group. All treatment‐naïve patients had been receiving current NA continuously for more than 1 year until the end of the follow‐up. We analyzed the accuracy of predictive risk score using the area under receiver operating characteristic curve. The albumin–bilirubin (ALBI) score was significantly improved by NA therapy (−0.171 ± 0.396; p < 0.001 at Week 48). A total of 72 (8.0%) patients developed HCC over a median follow‐up of 6.2 (1.03–15.7) years. An independent predictive factor of HCC development was older age, cirrhosis, lower platelet counts at baseline and ALBI score, and alpha‐fetoprotein (AFP) at 1 year after NA therapy according to multivariate analysis. The accuracy was assessed using the PAGE‐B, mPAGE‐B, aMAP, APA‐B, and REAL‐B scores that included these factors. Discrimination was generally acceptable for these models. aMAP and REAL‐B demonstrated high discrimination with 0.866/0.862 and 0.833/0.859 for 3‐ and 5‐year prediction from the status of 1 year after NA therapy, respectively. Baseline age and platelet count, as well as ALBI and AFP one year after NA, were useful for stratifying carcinogenesis risk. The aMAP and REAL‐B scores were validated with high accuracy in Japanese CHB patients.

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Section: Discussionsupporting

confidence: 73%

Risk factors for hepatocellular carcinoma at baseline and 1 year after initiation of nucleos(t)ide analog therapy for chronic hepatitis B

Kaneko

Kurosaki

Mashiba

et al. 2022

Journal of Medical Virology

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“…To our knowledge, at least 10 risk models have been developed to predict the risk of HCC in CHB patients receiving NA therapy [ 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 31 , 32 ]. All of them were developed from a mixed population with or without cirrhosis (19.1–50.2% with cirrhosis).…”

Section: Discussionmentioning

confidence: 99%

“…All of them were developed from a mixed population with or without cirrhosis (19.1–50.2% with cirrhosis). A recent cohort study from the United States demonstrated that three models (APA-B, REAL-B and AASL-HCC) developed from patients receiving NA treatment and one model (RWS-HCC) developed from predominantly treatment-naïve patients exhibited the highest AUROCs (all > 0.80) for predicting 3-year HCC risk [ 6 , 10 , 11 , 14 , 15 ]. Common parameters of these four risk models such as age, cirrhosis or platelet count and AFP are documented risk factors for HCC.…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, some risk prediction models of HCC in patients with chronic hepatitis B (CHB) who received long-term NA treatment have been developed [ 3 , 4 , 5 , 6 , 7 , 8 , 9 ]. Notably, a recent study from the United States compared the predictive performance of 10 risk prediction models and demonstrated that APA-B, AASL-HCC, REAL-B and RWS-HCC exhibited an area under the receiver operating characteristic curve (AUROC) of >0.80 for predicting 3-year HCC risk [ 4 , 6 , 7 , 10 , 11 , 12 , 13 , 14 , 15 ]. However, these risk scores were developed from a mixed population with or without cirrhosis.…”

Section: Introductionmentioning

confidence: 99%

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A Mac-2 Binding Protein Glycosylation Isomer-Based Risk Model Predicts Hepatocellular Carcinoma in HBV-Related Cirrhotic Patients on Antiviral Therapy

Chen

Wang

et al. 2022

Cancers

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Mac-2 binding protein glycosylation isomer (M2BPGi) has not been used in a risk score to predict hepatocellular carcinoma (HCC). We enrolled 1003 patients with chronic hepatitis B and cirrhosis receiving entecavir or tenofovir therapy for more than12 months to construct an HCC risk score. In the development cohort, Cox regression analysis identified male gender, age, platelet count, AFP and M2BPGi levels at 12 months of treatment as independent risk factors of HCC. We developed the HCC risk prediction model, the ASPAM-B score, based on age, sex, platelet count, AFP and M2BPGi levels at 12 months of treatment, with the total scores ranging from 0 to 11.5. This risk model accurately classified patients into low (0–3.5), medium (4–7), and high (>7) risk in the development and validation groups (p < 0.001). The areas under the receiver operating characteristic curve (AUROC) of 3-, 5- and 9-year risks of HCC were 0.742, 0.728 and 0.719, respectively, in the development cohort. All AUROC between the ASPAM-B and APA-B, PAGE-B, RWS-HCC and THRI scores at 3–9 years were significantly different. The M2BPGi-based risk model exhibited good discriminant function in predicting HCC in cirrhotic patients who received long-term antiviral treatment.

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“…3 ≥2 ICD-10 codes B180 or B181 in hospital claims data b separated by ≥6 months Mahajan et al 13 No. 4 Qualitative and quantitative tests for HBV DNA in serum (NABM code 4120) followed by the dispensing of entecavir or tenofovir based medications Kim et al 37 No. 5 ≥1 criteria among:…”

Section: Author (Reference) Amentioning

confidence: 99%

Performance of algorithms for identifying patients with chronic hepatitis B or C infection in the french health insurance claims databases using the ANRS CO22 HEPATHER cohort

Lam

Fontaine

Lapidus

et al. 2022

Journal of Viral Hepatitis

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Comparative performance of risk prediction models for hepatitis B-related hepatocellular carcinoma in the United States

Cited by 27 publications

References 22 publications

Risk factors for hepatocellular carcinoma at baseline and 1 year after initiation of nucleos(t)ide analog therapy for chronic hepatitis B

Risk factors for hepatocellular carcinoma at baseline and 1 year after initiation of nucleos(t)ide analog therapy for chronic hepatitis B

A Mac-2 Binding Protein Glycosylation Isomer-Based Risk Model Predicts Hepatocellular Carcinoma in HBV-Related Cirrhotic Patients on Antiviral Therapy

Performance of algorithms for identifying patients with chronic hepatitis B or C infection in the french health insurance claims databases using the ANRS CO22 HEPATHER cohort

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