Accès ouvert déclaré2023article
External validation of the PAGE-B score for HCC risk prediction in people living with HIV/HBV coinfection
Bernard Surial, Adrià Ramírez Mena, Marie Roumet, Andreas Limacher, Colette Smit, Olivier Leleux, Amanda Mocroft, Marc van der Valk, Fabrice Bonnet, Lars Peters, Jürgen K. Rockstroh, Huldrych F. Günthard, Annalisa Berzigotti, Andri Rauch, Gilles Wandeler, Irène A. Abela, Karoline Aebi‐Popp, Nektarios Anagnostopoulos, Manuel Battegay, Enos Bernasconi, Dominique L. Braun, Heiner C. Bucher, Alexandra Calmy, Matthias Cavassini, Angela Ciuffi, G Dollenmaier, Michael E. Egger, Luigia Elzi, Jan Fehr, Jacques Fellay, Hansjakob Furrer, Christoph A. Fux, Anna Hachfeld, David Haerry, Barbara Hasse, Hans H. Hirsch, Matthias Hoffmann, Irène Hösli, M Huber, D. Jackson-Perry, Christian R. Kahlert, Laurent Kaiser, Olivia Keiser, Thomas Klimkait, Roger D. Kouyos, Helen Kovari, Katharina Kusejko, Niklaus Daniel Labhardt, Karoline Leuzinger, Begoña Martínez de Tejada, Catia Marzolini, Karin J. Metzner, N Müller, Johannes Nemeth, Dunja Nicca, Julia Notter, P Paioni, Giuseppe Pantaleo, Matthieu Perreau, Luisa Salazar‐Vizcaya, Peter Schmid, René Speck, M Stöckle, Philip Tarr, Alexandra Trkola, Maja Weisser, Sabine Yerly, Suzanne E. Geerlings, Abraham Goorhuis, Victoria Harris, Joppe W. Hovius, B. Lempkes, F.J.B. Nellen, T. van der Poll, Jan M. Prins, V. Spoorenberg, Michèle van Vugt, W. Joost Wiersinga, F.W.M.N. Wit, C. Bruins, J. van Eden, I.J. Hylkema-van den Bout, A M H van Hes, F J J Pijnappel, S Smalhout, Annouschka M. Weijsenfeld, Nicole Back, B. Berkhout, Marion Cornelissen, Robin van Houdt, Marcel Jonges, Suzanne Jurriaans, C. Schinkel, Katja C. Wolthers, Hans L. Zaaijer, Edgar J.G. Peters, Reshma Autar, Marije K. Bomers, Kim Sigaloff, M. Heitmuller, Liedewij Laan, Marcel van den Berge, Arjan Stegeman, S. Baas, L. Hage de Looff, Andreas van Arkel, Jiřı́ Stöhr, Bas Wintermans, M.J.H. Pronk, Heidi Ammerlaan, E.S. de Munnik, Birgit Deiman, A R Jansz, Volkher Scharnhorst, Jeroen H. T. Tjhie, M.C.A. Wegdam, A. van Eeden, Elske Hoornenborg, Jeannine F. Nellen, W. Alers, L. Elsenburg, H. Nobel, M.E.E. van Kasteren, Marvin A. H. Berrevoets, A.E. Brouwer, B.A.F.M. de Kruijf-van de Wiel, Andrew L. Adams, M. Pawels-van Rijkevoorsel, A. G. M. Buiting, J.L. Murck, Casper Rokx, Adam A. Anas, Hannelore I. Bax, Eric C. M. Van Gorp, Martim Melo, Els van Nood, Jan Nouwen, Bart Rijnders, Carolina A. M. Schurink, Lennert Slobbe, T.E.M.S. de Vries-Sluijs, N. Bassant, J.E.A. van Beek, M. Vriesde, L.M. van Zonneveld, Joris R. de Groot, Jeroen J. A. van Kampen, Marion Koopmans, Janette Rahamat‐Langendoen, Judith Branger, Reuben Douma, A.S. Cents-Bosma, C.J.H.M. Duijf-van de Ven, Emile F. Schippers, Cees van Nieuwkoop, J. Geilings, Steven van Winden, G. van der Hut, Nathalie D. van Burgel, Eliane M.S. Leyten, L. B. S. Gelinck, Femke Mollema, G.S. Wildenbeest, T. H. Nguyen, P. H. P. Groeneveld, J.W. Bouwhuis, Adriana J. J. Lammers, A. G. W. van Hulzen, S. Kraan, M.S.M. Kruiper, G.L. van der Bliek, Petra Bor, S.B. Debast, Gertjan H.J. Wagenvoort, Anna H.E. Roukens, Mark de Boer, H. Jolink, Merel M. C. Lambregts, Henk Scheper, W. Dorama, Natasja van Holten, Eric C. J. Claas, Els Wessels, Jan G. den Hollander, Rachida el Moussaoui, Katalin Pogány, C.J. Brouwer, D. Heida-Peters, Emma R. Mulder, Jesper Smit, D. Struik-Kalkman, T.G.C.M. van Niekerk, Oscar Pontesilli, Carla van Tienen, S.H. Lowe, Astrid M. L. Oude Lashof, Dirk Posthouwer, Marlies E van Wolfswinkel, Robin Ackens, Kristina Burgers, M. Elasri, J. Schippers, Thomas Havenith, Marit G. A. van Vonderen, Linda M. Kampschreur, Michelle Broekhuizen, S, Faber Faber, A. Al Moujahid, G. J. Kootstra, Corine Delsing, Matthijs Plas, L. Scheiberlich, W. Kortmann, G. van Twillert, R. Renckens, Jiri F. P. Wagenaar, D. Ruiter-Pronk, F.A. van Truijen-Oud, J. W. T. Cohen Stuart, Marieke Hoogewerf, Wouter Rozemeijer, J. C. Sinnige, Kees Brinkman, G.E.L. van den Berk, Kamilla D. Lettinga, Marina de Regt, W.E.M. Schouten, Janneke E. Stalenhoef, Jan A. Veenstra, S.M.E. Vrouenraets, H. Blaauw, G.F. Geerders, M.J. Kleene, M. Knapen, Marjolein Kok, I.B. van der Meché, A.J.M. Toonen, S. Wijnands, E. Wttewaal, David Kwa, Thijs van de Laar, Reinout van Crevel, Koen van Aerde, A. Dofferhoff, Stefanie Henriet, H.J.M. ter Hofstede, Jacobien J. Hoogerwerf, Olivier Richel, M. Albers, K.J.T. Grintjes-Huisman, M. de Haan, M. Marneef, Matthew B. B. McCall, David M. Burger, Elisabeth H. Gisolf, Mark A. A. Claassen, R.J. Hassing, G. ter Beest, P.H.M. van Bentum, Maureen Gelling, Y. Neijland, C.M.A. Swanink, M. Klein Velderman, S.F.L. van Lelyveld, Robin Soetekouw, L.M.M. van der Prijt, J. van der Swaluw, Jayant Kalpoe, Alex Wagemakers, A. Vahidnia, Fanny N. Lauw, D.W.M. Verhagen, Michiel P. van Wijk, Wouter F.W. Bierman, Margreet Bakker, R.A. van Bentum, M.A. van den Boomgaard, Johanneke Kleinnijenhuis, E. Kloeze, Ananja Middel, Douwe F. Postma, H Schenk, Ymkje Stienstra, Marjan Wouthuyzen‐Bakker, André Boonstra, H. de Jonge, M.M.M. Maerman, D.A. de Weerd, K.J. van Eije, Marjolein Knoester, Coretta van Leer‐Buter, Hubert G.M. Niesters, Tania Mudrikova, Roos E. Barth, A.H.W. Bruns, Pauline M. Ellerbroek, M.P.M. Hensgens, Jan Jelrik Oosterheert, E.M. Schadd, Annelies Verbon, Berend J. van Welzen, H. Berends, B.M.G. Griffioen-van Santen, I. de Kroon, Frans M. Verduyn Lunel, Annemarie M. J. Wensing, S Zaheri, Anders Boyd, Daniela Bezemer, A.I. van Sighem, M Hillebregt, T.J. Woudstra, T. Rutkens, D.P. Bergsma, N.M. Brétin, K.J. Lelivelt, Linette Sande, K.M. Visser.S.T. van der Vliet, Fleur P. Paling, L.G.M. de Groot-Berndsen, Marjan van den Akker, Richard B. Alexander, Y. Bakker, A el Berkaoui, M. Bezemer-Goedhart, E.A. Djoechro, M. Groters, L.E. Koster, C.R.E. Lodewijk, E.G.A. Lucas, L. Munjishvili, B Peeck, C.M.J. Ree, R. Regtop, A.F. van Rijk, Y.M.C. Ruijs-Tiggelman, P.P. Schnörr, Maartje Schoorl, E. Tuijn, D.P. Veenenberg, E.C.M. Witte, Igor Karpov, M. Losso, Jens Lundgren, Inka Aho, Lasse Dam Rasmussen, Petr Novák, Christian Pradier, Nikoloz Chkhartishvili, Raimonda Matulionytė, Cristiana Oprea, Justyna Kowalska, Josip Begovać, José M. Miró, Giovanni Guaraldi, Roger Paredes, Jens Fromholt Larsen, Bastian Neesgaard, Nadine Jaschinski, O Fursa, David Raben, D. Kristensen, Andrew H. Fischer, Søren Krogh Jensen, T W Elsing, Masyar Gardizi, Andrew Phillips, J. Reekie, Alessandro Cozzi‐Lepri, Annegret Pelchen–Matthews, Ashley Roen, E Tusch, Wade Bannister, Pantxika Bellecave, Patrick Blanco, S. Bouchet, Dominique Breilh, C. Cazanave, S Desjardin, Valérie Gaborieau, Anne Gimbert, Mojgan Hessamfar, L. Lacaze-Buzy, D. Lacoste, M.E. Lafon, E. Lazaro, F. Le Marec, G. Le Moal, D. Malvy, Lucie Marchand, P. Mercié, David B. Neau, I. Pellegrin, Adélaïde Perrier, Ventzislava Petrov–Sanchez, Marc-Olivier Vareil, Linda Wittkop, Nadine Bernard, D. Bronnimann H. Chaussade, D. Dondia, P. Duffau, I. Faure, Philippe Morlat, E. Mériglier, F. Paccalin, E. Riebero, C. Rivoisy, M.A. Vandenhende, L. Barthod, F. Dauchy, A. Desclaux, M. Ducours, H. Dutronc, A. Duvignaud, Jorge H. Leitão, M Lescure, Duc Thanh Nguyen, T. Pistone, M. Puges, G Wirth, Carine Courtault, Fabrice Camou, C. Greib, J.L. Pellegrin, E. Rivière, J.F. Viallard, Y. Imbert, M. Thierry-Mieg, P Rispal, O. Caubet, H. Ferrand, S. Tchamgoué, Sophie Farbos, H. Wille, L. Caunegre, Y Gérard, F. Osorio-Perez, I. Chossat, Gregory Iles, M. Labasse-Depis, F. Lacassin, A. Barret, Bernard Castan, J. Koffi, N. Rouanes, A. Saunier, J.B. Zabbe, Gilles Dumondin, Guillaume Béraud, M. Catroux, Magali Garcia, Vincent Giraud, Jean-Philippe Martellosio, F. Roblot, T Pasdeloup, A. Riché, Marine Grosset, S. Males, C. Ngo Bell, C. Carpentier, Virology P. Bellecave, C. Tumiotto, G. Miremeont-Salamé, D. Arma, G. Arnou, M.J. Blaizeau, Pelayo Camps, M. Decoin, Sandrine Delveaux, F. Diarra, L. Gabrea, S. Lawson-Ayayi, E. Lenaud, D. Plainchamps, A. Pougetoux, B. Uwamaliya, K. Zara, Viola Conte, M. Gapillout
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19Institutions associées
7Pays d’affiliation
Résumé fourni par la source
BACKGROUND & AIMS: HBV coinfection is common among people living with HIV (PLWH) and is the most important cause of hepatocellular carcinoma (HCC). While risk prediction tools for HCC have been validated in patients with HBV monoinfection, they have not been evaluated in PLWH. Thus, we performed an external validation of PAGE-B in people with HIV/HBV coinfection. METHODS: We included data on PLWH from four European cohorts who were positive for HBsAg and did not have HCC before starting tenofovir. We estimated the predictive performance of PAGE-B for HCC occurrence over 15 years in patients receiving tenofovir-containing antiretroviral therapy. Model discrimination was assessed after multiple imputation using Cox regression with the prognostic index as a covariate, and by calculating Harrell's c-index. Calibration was assessed by comparing our cumulative incidence with the PAGE-B derivation study using Kaplan-Meier curves. RESULTS: In total, 2,963 individuals with HIV/HBV coinfection on tenofovir-containing antiretroviral therapy were included. PAGE-B was <10 in 26.5%, 10-17 in 57.7%, and ≥18 in 15.7% of patients. Within a median follow-up of 9.6 years, HCC occurred in 68 individuals (2.58/1,000 patient-years, 95% CI 2.03-3.27). The regression slope of the prognostic index for developing HCC within 15 years was 0.93 (95% CI 0.61-1.25), and the pooled c-index was 0.77 (range 0.73-0.80), both indicating good model discrimination. The cumulative incidence of HCC was lower in our study compared to the derivation study. A PAGE-B cut-off of <10 had a negative predictive value of 99.4% for the development of HCC within 5 years. Restricting efforts to individuals with a PAGE-B of ≥10 would spare unnecessary HCC screening in 27% of individuals. CONCLUSIONS: For individuals with HIV/HBV coinfection, PAGE-B is a valid tool to determine the need for HCC screening. IMPACT AND IMPLICATIONS: Chronic HBV infection is the most important cause of hepatocellular carcinoma (HCC) among people living with HIV. Valid risk prediction may enable better targeting of HCC screening efforts to high-risk individuals. We aimed to validate PAGE-B, a risk prediction tool that is based on age, sex, and platelets, in 2,963 individuals with HIV/HBV coinfection who received tenofovir-containing antiretroviral therapy. In the present study, PAGE-B showed good discrimination, adequate calibration, and a cut-off of <10 had a negative predictive value of 99.4% for the development of HCC within 5 years. These results indicate that PAGE-B is a simple and valid risk prediction tool to determine the need for HCC screening among people living with HIV and HBV.
Sujets associés
Hepatitis B Virus StudiesHepatocellular Carcinoma Treatment and PrognosisPancreatic and Hepatic Oncology Research