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