Progression Rates by Age, Sex, Treatment, and Disease Activity by AASLD and EASL Criteria: Data for Precision Medicine

Jiyoon Park, An K. Le, Tai Chung Tseng, Ming Lun Yeh, Dae Won Jun, Huy Trinh, Grace L.H. Wong, Chien Hung Chen, Cheng Yuan Peng, Sung Eun Kim, Hyunwoo Oh, Min Sun Kwak, Ka Shing Cheung, Hidenori Toyoda, Yao Chun Hsu, Jae Yoon Jeong, Eileen L. Yoon, Teerapat Ungtrakul, Jian Zhang, Qing XieSang Bong Ahn, Masaru Enomoto, Jae Jun Shim, Chris Cunningham, Soung Won Jeong, Yong Kyun Cho, Eiichi Ogawa, Rui Huang, Dong Hyun Lee, Hirokazu Takahashi, Pei Chien Tsai, Chung Feng Huang, Chia Yen Dai, Cheng Hao Tseng, Satoshi Yasuda, Ritsuzo Kozuka, Jiayi Li, Christopher Wong, Clifford C. Wong, Changqing Zhao, Joseph Hoang, Yuichiro Eguchi, Chao Wu, Yasuhito Tanaka, Ed Gane, Tawesak Tanwandee, Ramsey Cheung, Man Fung Yuen, Hyo Suk Lee, Ming Lung Yu, Jia Horng Kao, Hwai I. Yang, Mindie H. Nguyen

Research output: Contribution to journalArticlepeer-review

Abstract

Background & AIMS: Antiviral treatment criteria are based on disease progression risk, and hepatocellular carcinoma (HCC) surveillance recommendations for patients with chronic hepatitis B (CHB) without cirrhosis is based on an annual incidence threshold of 0.2%. However, accurate and precise disease progression estimate data are limited. Thus, we aimed to determine rates of cirrhosis and HCC development stratified by age, sex, treatment status, and disease activity based on the 2018 American Association for the Study of Liver Diseases and 2017 European Association for the Study of the Liver guidelines. Methods: We analyzed 18,338 patients (8914 treated, 9424 untreated) from 6 centers from the United States and 27 centers from Asia-Pacific countries. The Kaplan-Meier method was used to estimate annual progression rates to cirrhosis or HCC in person-years. Results: The cohort was 63% male, with a mean age of 46.19 years, with baseline cirrhosis of 14.3% and median follow up of 9.60 years. By American Association for the Study of Liver Diseases criteria, depending on age, sex, and disease activity, annual incidence rates ranged from 0.07% to 3.94% for cirrhosis, from 0.04% to 2.19% for HCC in patients without cirrhosis, and from 0.40% to 8.83% for HCC in patients with cirrhosis. Several subgroups of patients without cirrhosis including males younger than 40 years of age and females younger than 50 years of age had annual HCC risk near or exceeding 0.2%. Similar results were found using European Association for the Study of the Liver criteria. Conclusion: There is great variability in CHB disease progression rates even among “lower-risk” populations. Future CHB modeling studies, public health planning, and HCC surveillance recommendation should be based on more precise disease progression rates based on sex, age, and disease activity, plus treatment status.

Original languageEnglish
JournalClinical Gastroenterology and Hepatology
DOIs
Publication statusAccepted/In press - 2021

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

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