George V Papatheodoridis1, George N Dalekos2, Cihan Yurdaydin3, Maria Buti4, John Goulis5, Pauline Arends6, Vana Sypsa7, Spilios Manolakopoulos8, Giampaolo Mangia9, Nikolaos Gatselis2, Onur Keskın3, Savvoula Savvidou5, Bettina E Hansen6, Christos Papaioannou8, Kostantinos Galanis2, Ramazan Idilman3, Massimo Colombo9, Rafael Esteban4, Harry L A Janssen10, Pietro Lampertico9. 1. Academic Department of Gastroenterology, Laiko General Hospital, Athens University Medical School, Athens, Greece; 2nd Department of Internal Medicine, Athens University Medical School, Hippokratio Hospital of Athens, Athens, Greece. Electronic address: gepapath@med.uoa.gr. 2. Department of Medicine and Research Laboratory of Internal Medicine, School of Medicine, University of Thessaly, Larissa, Greece. 3. Department of Gastroenterology, University of Ankara Medical School, Ankara, Turkey. 4. Hospital General Universitario Valle Hebron and Ciberehd, Barcelona, Spain. 5. Department of Internal Medicine, Αristotle University of Thessaloniki Medical School, Thessaloniki, Greece. 6. Department of Gastroenterology & Hepatology, ErasmusMC, Rotterdam, The Netherlands. 7. Department of Hygiene, Epidemiology & Medical Statistics, Athens University Medical School, Athens, Greece. 8. 2nd Department of Internal Medicine, Athens University Medical School, Hippokratio Hospital of Athens, Athens, Greece. 9. Division of Gastroenterology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milano, Italy. 10. Department of Gastroenterology & Hepatology, ErasmusMC, Rotterdam, The Netherlands; Liver Clinic, Toronto Western & General Hospital, University Health Network, Toronto, ON, Canada.
Abstract
BACKGROUND & AIMS: The risk of hepatocellular carcinoma (HCC) in Caucasian patients with chronic hepatitis B (CHB), treated with entecavir (ETV) or tenofovir (TDF), is unclear. We evaluated the incidence and predictors of HCC and the accuracy of existing HCC risk scores in Caucasian CHB patients receiving ETV/TDF. METHODS: This large, multicentre, retrospective cohort study included 1666 adult Caucasian CHB patients under ETV/TDF for 39 months. CHB without cirrhosis, compensated and decompensated cirrhosis were present in 67%, 39%, and 3% of patients, respectively. The predictability of baseline parameters and three risk scores (GAG-HCC, CU-HCC, and REACH-B), developed in Asian patients, was assessed. RESULTS: The cumulative probability of HCC was 1.3%, 3.4%, and 8.7% at year-1, year-3, and year-5 after ETV/TDF onset. Older age and lower platelets were strong independent HCC predictors in the total population and in the subgroups of cirrhotic and non-cirrhotic patients, while liver disease severity was an independent HCC predictor in the total population and in the cirrhotics. GAG-HCC, CU-HCC, and REACH-B risk scores were associated with HCC development only in the univariable but not in the multivariable analyses and offered poor to modest predictability. CONCLUSIONS: HCC can still develop in Caucasian CHB patients treated with ETV/TDF. Besides the well-known predictors of HCC, such as older age, male gender and more advanced liver disease, lower platelets represent an independent factor of higher HCC risk. The applicability and predictability of HCC risk scores developed in Asian patients are poor or modest in Caucasian CHB patients, for whom different risk scores are required.
BACKGROUND & AIMS: The risk of hepatocellular carcinoma (HCC) in Caucasian patients with chronic hepatitis B (CHB), treated with entecavir (ETV) or tenofovir (TDF), is unclear. We evaluated the incidence and predictors of HCC and the accuracy of existing HCC risk scores in Caucasian CHB patients receiving ETV/TDF. METHODS: This large, multicentre, retrospective cohort study included 1666 adult Caucasian CHB patients under ETV/TDF for 39 months. CHB without cirrhosis, compensated and decompensated cirrhosis were present in 67%, 39%, and 3% of patients, respectively. The predictability of baseline parameters and three risk scores (GAG-HCC, CU-HCC, and REACH-B), developed in Asian patients, was assessed. RESULTS: The cumulative probability of HCC was 1.3%, 3.4%, and 8.7% at year-1, year-3, and year-5 after ETV/TDF onset. Older age and lower platelets were strong independent HCC predictors in the total population and in the subgroups of cirrhotic and non-cirrhotic patients, while liver disease severity was an independent HCC predictor in the total population and in the cirrhotics. GAG-HCC, CU-HCC, and REACH-B risk scores were associated with HCC development only in the univariable but not in the multivariable analyses and offered poor to modest predictability. CONCLUSIONS: HCC can still develop in Caucasian CHB patients treated with ETV/TDF. Besides the well-known predictors of HCC, such as older age, male gender and more advanced liver disease, lower platelets represent an independent factor of higher HCC risk. The applicability and predictability of HCC risk scores developed in Asian patients are poor or modest in Caucasian CHB patients, for whom different risk scores are required.
Authors: Norah A Terrault; Anna S F Lok; Brian J McMahon; Kyong-Mi Chang; Jessica P Hwang; Maureen M Jonas; Robert S Brown; Natalie H Bzowej; John B Wong Journal: Hepatology Date: 2018-04 Impact factor: 17.425
Authors: Joseph Ahn; Joseph K Lim; Hannah M Lee; Anna S Lok; Mindie Nguyen; Calvin Q Pan; Ajitha Mannalithara; Helen Te; K Rajender Reddy; Huy Trinh; Danny Chu; Tram Tran; Daryl Lau; Truong-Sinh Leduc; Albert Min; Loc Trong Le; Ho Bae; Sang Van Tran; Son Do; Hie-Won L Hann; Clifford Wong; Steven Han; Anjana Pillai; James S Park; Myron Tong; Steve Scaglione; Jocelyn Woog; W Ray Kim Journal: Am J Gastroenterol Date: 2016-06-21 Impact factor: 10.864
Authors: Antoine Jaquet; Boris Tchounga; Aristophane Tanon; Aklesso Bagny; Didier K Ekouevi; Hamar A Traore; Annie J Sasco; Moussa Maiga; François Dabis Journal: Int J Cancer Date: 2018-04-10 Impact factor: 7.396
Authors: S K Sarin; M Kumar; G K Lau; Z Abbas; H L Y Chan; C J Chen; D S Chen; H L Chen; P J Chen; R N Chien; A K Dokmeci; Ed Gane; J L Hou; W Jafri; J Jia; J H Kim; C L Lai; H C Lee; S G Lim; C J Liu; S Locarnini; M Al Mahtab; R Mohamed; M Omata; J Park; T Piratvisuth; B C Sharma; J Sollano; F S Wang; L Wei; M F Yuen; S S Zheng; J H Kao Journal: Hepatol Int Date: 2015-11-13 Impact factor: 6.047