PAGE-B incorporating moderate HBV DNA levels predicts risk of HCC among patients entering into HBeAg-positive chronic hepatitis B
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Le résumé fourni par la source
Background & Aims Recent studies reported that moderate HBV DNA levels are significantly associated with hepatocellular carcinoma (HCC) risk in hepatitis B e antigen (HBeAg)-positive, non-cirrhotic patients with chronic hepatitis B (CHB). We aimed to develop and validate a new risk score to predict HCC development using baseline moderate HBV DNA levels in patients entering into HBeAg-positive CHB from chronic infection. Methods This multicenter cohort study recruited 3,585 HBeAg-positive, non-cirrhotic patients who started antiviral treatment with entecavir or tenofovir disoproxil fumarate at phase change into CHB from chronic infection in 23 tertiary university-affiliated hospitals of South Korea (2012–2020). A new HCC risk score (PAGED-B) was developed (training cohort, n = 2,367) based on multivariable Cox models. Internal validation using bootstrap sampling and external validation (validation cohort, n = 1,218) were performed. Results Sixty (1.7%) patients developed HCC (median follow-up, 5.4 years). In the training cohort, age, gender, platelets, diabetes and moderate HBV DNA levels (5.00–7.99 log 10 IU/ml) were independently associated with HCC development; the PAGED-B score (based on these five predictors) showed a time-dependent AUROC of 0.81 for the prediction of HCC development at 5 years. In the validation cohort, the AUROC of PAGED-B was 0.85, significantly higher than for other risk scores (PAGE-B, mPAGE-B, CAMD, and REAL-B). When stratified by the PAGED-B score, the HCC risk was significantly higher in high-risk patients than in low-risk patients (sub-distribution hazard ratio = 8.43 in the training and 11.59 in the validation cohorts, all p <0.001). Conclusions The newly established PAGED-B score may enable risk stratification for HCC at the time of transition into HBeAg-positive CHB. Impact and implications In this study, we developed and validated a new risk score to predict hepatocellular carcinoma (HCC) development in patients entering into hepatitis B e antigen (HBeAg)-positive chronic hepatitis B (CHB) from chronic infection. The newly established PAGED-B score, which included baseline moderate HBV DNA levels (5–8 log 10 IU/ml), improved on the predictive performance of prior risk scores. Based on a patient's age, gender, diabetic status, platelet count, and moderate DNA levels (5–8 log 10 IU/ml) at the phase change into CHB from chronic infection, the PAGED-B score represents a reliable and easily available risk score to predict HCC development during the first 5 years of antiviral treatment in HBeAg-positive patients entering into CHB. With a scoring range from 0 to 12 points, the PAGED-B score significantly differentiated the 5-year HCC risk: low <7 points and high ≥7 points.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- PAGE-B incorporating moderate HBV DNA levels predicts risk of HCC among patients entering into HBeAg-positive chronic hepatitis B
- Date Crossref
- 01/01/2024
- Éditeur
- Elsevier BV
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Ewha Womans University Department of Internal Medicine pays non établi dans la noticeUniversité ou école supérieure
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Ewha Womans University Medical Center pays non établi dans la noticeÉtablissement de santé
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National and Kapodistrian University of Athens Department of Gastroenterology pays non établi dans la noticeUniversité ou école supérieure
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Laiko General Hospital of Athens pays non établi dans la noticeÉtablissement de santé
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Ewha Womans University Seoul Hospital pays non établi dans la noticeÉtablissement de santé
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National University College Department of Internal Medicine and Liver Research Institute pays non établi dans la noticeUniversité ou école supérieure
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Yonsei University Department of Internal Medicine pays non établi dans la noticeUniversité ou école supérieure
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Severance Hospital Yonsei Liver Center pays non établi dans la noticeÉtablissement de santé
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Yonsei University Health System pays non établi dans la noticeÉtablissement de santé
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Seoul National University pays non établi dans la noticeUniversité ou école supérieure
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Hanyang University Department of Internal Medicine pays non établi dans la noticeUniversité ou école supérieure
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Koç University Department of Gastroenterology & Hepatology pays non établi dans la noticeUniversité ou école supérieure
Department of Internal Medicine — Ewha Womans University, Ewha Womans University Medical Center et Department of Gastroenterology — National and Kapodistrian University of Athens, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.