Real-world effectiveness from the asia pacific rim liver consortium for hbv risk score for the prediction of hepatocellular carcinoma in chronic hepatitis b patients treated with oral antiviral therapy

Hwai I. Yang, Ming Lun Yeh, Grace L. Wong, Cheng Yuan Peng, Chien Hung Chen, Huy N. Trinh, Ka Shing Cheung, Qing Xie, Tung Hung Su, Ritsuzo Kozuka, Dong Hyun Lee, Eiichi Ogawa, Changqing Zhao, Hui Bin Ning, Rui Huang, Jiayi Li, Jian Q. Zhang, Tatsuya Ide, Huichun Xing, Shinji IwaneHirokazu Takahashi, Christopher Wong, Clifford Wong, Chia Hsin Lin, Joseph Hoang, An Le, Linda Henry, Hidenori Toyoda, Yoshiyuki Ueno, Edward J. Gane, Yuichiro Eguchi, Masayuki Kurosaki, Chao Wu, Chenghai Liu, Jia Shang, Norihiro Furusyo, Masaru Enomoto, Jia Horng Kao, Man Fung Yuen, Ming Lung Yu, Mindie H. Nguyen

Research output: Contribution to journalArticlepeer-review

12 Citations (Scopus)

Abstract

Background. Patients on oral antiviral (OAV) therapy remain at hepatocellular carcinoma (HCC) risk. Risk prediction tools distinguishing treated patients with residual HCC risk are limited. The aim of this study was to develop an accurate, precise, simple-to-use HCC risk score using routine clinical variables among a treated Asian cohort. Methods. Adult Asian chronic hepatitis B (CHB) patients on OAV were recruited from 25 centers in the United States and the Asia-Pacific region. Excluded persons were coinfected with hepatitis C, D, or human immunodeficiency virus, had HCC before or within 1 year of study entry, or their follow-up was <1 year. Patients were randomized to derivation and validation cohorts on a 2:1 ratio. Statistically significant predictors from multivariate modeling formed the Real-world Effectiveness from the Asia Pacific Rim Liver Consortium for HBV (REAL-B) score. Results. A total of 8048 patients were randomized to the derivation (n = 5365) or validation group (n = 2683). The REAL-B model included 7 variables (male gender, age, alcohol use, diabetes, baseline cirrhosis, platelet count, and alpha fetoprotein), and scores were categorized as follows: 0-3 low risk, 4-7 moderate risk, and 8-13 high risk. Area under receiver operating characteristics were >0.80 for HCC risk at 3, 5, and 10 years, and these were significantly higher than other risk models (p <.001). Conclusions. The REAL-B score provides 3 distinct risk categories for HCC development in Asian CHB patients on OAV guiding HCC surveillance strategy.

Original languageEnglish
Pages (from-to)389-399
Number of pages11
JournalJournal of Infectious Diseases
Volume221
Issue number3
DOIs
Publication statusPublished - 2020
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Infectious Diseases

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