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  • Wiley  (7)
  • Lee, Hye Won  (7)
  • Park, Soo Young  (7)
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  • Wiley  (7)
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  • 1
    Online Resource
    Online Resource
    A multi‐centre study of trends in hepatitis B virus‐related hepatocellular carcinoma risk over time during long‐term entecavir therapy
    Wiley ; 2020
    In:  Journal of Viral Hepatitis Vol. 27, No. 12 ( 2020-12), p. 1352-1358
    Details
    In: Journal of Viral Hepatitis, Wiley, Vol. 27, No. 12 ( 2020-12), p. 1352-1358
    Abstract: The risk of developing hepatitis B virus (HBV)‐related hepatocellular carcinoma (HCC) is reduced by antiviral therapy. Here, we evaluated the chronological trends in HCC development risk starting in 2007, when entecavir reimbursement was first initiated in South Korea. Treatment‐naïve patients with chronic hepatitis B (CHB) receiving entecavir 0.5 mg/d were stratified into three groups according to entecavir start time: early (2007‐2010), middle (2011‐2012) and late (2013‐2014) cohorts Among 2442 patients, cumulative probabilities of developing HCC after 1, 3 and 5 years were, respectively, 1.7%, 5.1%, and 8.2% (early cohort; n = 672); 1.5%, 5.1% and 8.9% (middle cohort; n = 757); and 1.2%, 5.3% and 10.6% (late cohort; n = 1013; P   〉  .05 between each pair). Older age, male, positive hepatitis B e antigen, liver cirrhosis, Child‐Pugh class B (vs A) and lower platelet count significantly predicted HCC development in univariate analysis ( P   〈  .001), whereas entecavir start time (early vs middle vs late cohorts) did not affect the risk of HCC development ( P  = .457). A multivariate analysis revealed that older age (adjusted hazard ratio [aHR]=1.041), male gender (aHR = 2.069), liver cirrhosis (aHR = 3.771) and Child‐Pugh class B (vs A, aHR = 1.548) were independently associated with an increased risk of HCC development, whereas higher platelet count was independently associated with a reduced risk of HCC development (aHR = 0.993; all P   〈  .05). In conclusion, the risk of developing HCC among patients receiving entecavir in South Korea has been stable since 2007. To establish more effective HCC surveillance programs, further studies regarding the carcinogenic roles of nonviral factors are required.
    Type of Medium: Online Resource
    ISSN: 1352-0504 , 1365-2893
    URL: Issue
    URL: Article
    DOI: 10.1111/jvh.v27.12
    DOI: 10.1111/jvh.13384
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2007924-2
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  • 2
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    Online Resource
    A machine learning model for predicting hepatocellular carcinoma risk in patients with chronic hepatitis B
    Wiley ; 2023
    In:  Liver International Vol. 43, No. 8 ( 2023-08), p. 1813-1821
    Details
    In: Liver International, Wiley, Vol. 43, No. 8 ( 2023-08), p. 1813-1821
    Abstract: Machine learning (ML) algorithms can be used to overcome the prognostic performance limitations of conventional hepatocellular carcinoma (HCC) risk models. We established and validated an ML‐based HCC predictive model optimized for patients with chronic hepatitis B (CHB) infections receiving antiviral therapy (AVT). Methods Treatment‐naïve CHB patients who were started entecavir (ETV) or tenofovir disoproxil fumarate (TDF) were enrolled. We used a training cohort ( n  = 960) to develop a novel ML model that predicted HCC development within 5 years and validated the model using an independent external cohort ( n  = 1937). ML algorithms consider all potential interactions and do not use predefined hypotheses. Results The mean age of the patients in the training cohort was 48 years, and most patients (68.9%) were men. During the median 59.3 (interquartile range 45.8–72.3) months of follow‐up, 69 (7.2%) patients developed HCC. Our ML‐based HCC risk prediction model had an area under the receiver‐operating characteristic curve (AUC) of 0.900, which was better than the AUCs of CAMD (0.778) and REAL B (0.772) (both p   〈  .05). The better performance of our model was maintained (AUC = 0.872 vs. 0.788 for CAMD and 0.801 for REAL B) in the validation cohort. Using cut‐off probabilities of 0.3 and 0.5, the cumulative incidence of HCC development differed significantly among the three risk groups ( p   〈  .001). Conclusions Our new ML model performed better than models in terms of predicting the risk of HCC development in CHB patients receiving AVT.
    Type of Medium: Online Resource
    ISSN: 1478-3223 , 1478-3231
    URL: Issue
    URL: Article
    DOI: 10.1111/liv.v43.8
    DOI: 10.1111/liv.15597
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2124684-1
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  • 3
    Online Resource
    Online Resource
    Long‐term effects of entecavir and tenofovir treatment on the fibrotic burden in patients with chronic hepatitis B
    Wiley ; 2022
    In:  Journal of Gastroenterology and Hepatology Vol. 37, No. 1 ( 2022-01), p. 200-207
    Details
    In: Journal of Gastroenterology and Hepatology, Wiley, Vol. 37, No. 1 ( 2022-01), p. 200-207
    Abstract: Antiviral therapy (AVT) induces fibrosis regression in patients with chronic hepatitis B. We investigated long‐term effects of entecavir (ETV) versus tenofovir (TDF) on fibrotic burden. Methods Treatment‐naïve chronic hepatitis B patients who had begun ETV or TDF were recruited from four tertiary hospitals. The aspartate aminotransferase‐to‐platelet ratio index (APRI) and fibrosis index based on four factors (FIB‐4) were used to determine fibrotic burden. Results In the entire population ( n  = 3277), although patients treated with ETV had higher baseline APRI (1.71 vs 1.07, P   〈  0.001) and FIB‐4 (3.60 vs 2.80, P   〈  0.001) than those treated with TDF, significant fibrosis regression was identified during 6 years of AVT in both ETV (APRI, mean 1.71 → 0.48, P   〈  0.001; FIB‐4, mean 3.60 → 2.21, P   〈  0.001) and TDF groups (APRI, mean 1.07 → 0.43, P   〈  0.001; FIB‐4, mean 2.80 → 2.19, P   〈  0.001). In patients without cirrhosis ( n  = 2366), baseline APRI was significantly higher in ETV group than in TDF group (1.72 vs 0.97, P   〈  0.001); however, they became similar after 6 months. Similarly, baseline FIB‐4 was significantly higher in ETV group than in TDF group (3.25 vs 2.35, P   〈  0.001), but became similar from 4 to 6 years. In patients with cirrhosis ( n  = 911), baseline APRI (1.70 vs 1.34, P   〈  0.001) and FIB‐4 (4.62 vs 3.91, P  = 0.005) were higher in ETV group than in TDF, however, both parameters became statistically similar from 6 months to 6 years. Conclusion Significant regression of APRI and FIB‐4 was observed during long‐term ETV and TDF treatment. Despite higher baseline fibrotic burden in ETV group, fibrotic burden between the groups eventually converged through significant fibrosis regression after 1 to 4 years of AVT.
    Type of Medium: Online Resource
    ISSN: 0815-9319 , 1440-1746
    URL: Issue
    URL: Article
    DOI: 10.1111/jgh.v37.1
    DOI: 10.1111/jgh.15678
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2006782-3
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  • 4
    Online Resource
    Online Resource
    Validation of risk prediction scores for hepatocellular carcinoma in patients with chronic hepatitis B treated with entecavir or tenofovir
    Wiley ; 2021
    In:  Journal of Viral Hepatitis Vol. 28, No. 1 ( 2021-01), p. 95-104
    Details
    In: Journal of Viral Hepatitis, Wiley, Vol. 28, No. 1 ( 2021-01), p. 95-104
    Abstract: Several prediction scores for the early detection of hepatocellular carcinoma (HCC) are available. We validated the predictive accuracy of age, albumin, sex, liver cirrhosis (AASL), RESCUE‐B, PAGE‐B and modified PAGE‐B (mPAGE‐B) scores in chronic hepatitis B (CHB) patients treated with entecavir (ETV) or tenofovir disoproxil fumarate (TDF). Between 2007 and 2014, 3171 patients were recruited (1645, ETV; 1517, TDF). The predictive accuracy of each prediction score was assessed. The mean age of the study population (1977 men; 1194 women) was 48.8 years. Liver cirrhosis was present in 1040 (32.8%) patients. During follow‐up (median, 58.2 months), 280 (8.8%) patients developed HCC; these patients were significantly older; more likely to be male; had significantly higher proportions of liver cirrhosis, hypertension and diabetes; and had significantly higher values for the four risk scores than those who did not develop HCC (all P   〈  .05). Older age (hazard ratio [HR] = 1.048), male sex (HR = 2.142), liver cirrhosis (HR = 3.144) and prolonged prothrombin time (HR = 2.589) were independently associated with an increased risk of HCC (all P   〈  .05), whereas a higher platelet count (HR = 0.996) was independently associated with a decreased risk of HCC ( P   〈  .05). The predictive accuracy of AASL score was the highest for 3‐ and 5‐year HCC predictions (areas under the curve [AUCs] = 0.818 and 0.816, respectively), followed by RESCUE‐B, PAGE‐B and mPAGE‐B scores (AUC = 0.780‐0.815 and 0.769‐0.814, respectively). In conclusion, four HCC prediction scores were assessed in Korean CHB patients treated with ETV or TDF. The AASL score showed the highest predictive accuracy.
    Type of Medium: Online Resource
    ISSN: 1352-0504 , 1365-2893
    URL: Issue
    URL: Article
    DOI: 10.1111/jvh.v28.1
    DOI: 10.1111/jvh.13411
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2007924-2
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  • 5
    Online Resource
    Online Resource
    Effect of tenofovir alafenamide vs. tenofovir disoproxil fumarate on hepatocellular carcinoma risk in chronic hepatitis B
    Wiley ; 2021
    In:  Journal of Viral Hepatitis Vol. 28, No. 11 ( 2021-11), p. 1570-1578
    Details
    In: Journal of Viral Hepatitis, Wiley, Vol. 28, No. 11 ( 2021-11), p. 1570-1578
    Abstract: It is unclear whether tenofovir disoproxil fumarate (TDF) or tenofovir alafenamide (TAF) is more effective for preventing hepatocellular carcinoma (HCC) development in patients with chronic hepatitis B (CHB). In this study, we compared the effectiveness of these two antiviral agents for preventing HCC. We included treatment‐naïve CHB patients undergoing antiviral therapy with TDF only (TDF group) or a TAF‐based regimen (TAF group) at three academic teaching hospitals from 2012 to 2019. The TAF group included patients receiving TAF as first‐line treatment and patients switching from TDF to TAF. Patients with decompensated cirrhosis or HCC at enrollment were excluded. Cumulative probabilities of HCC were assessed using Kaplan‐Meier methodology. In total, 2,117 patients were included: 1,832 in the TDF group and 285 in the TAF group. The annual HCC incidence was not significantly different between TDF and TAF groups: 1.66 vs. 1.19 per 100 person‐years [PY], respectively (multivariate analysis: adjusted hazard ratio [HR] 0.774 [reference: TDF group]; p  = .438). Male, liver cirrhosis, hepatitis B e antigen negativity, Fibrosis‐4 index 〉 3.25 and low albumin were independently associated with a higher risk of HCC. Propensity score‐matched and inverse probability of treatment weighting analyses yielded similar results: 1.56 vs. 1.19 per 100 PY, respectively (HR 1.175; p  = .708) and 1.66 vs. 1.29 per 100 PY, respectively (HR 0.888; p  = .446). The risk of HCC development was not significantly different between TDF and TAF groups of CHB patients. Further studies with a larger sample size and longer follow‐up are required to validate our results.
    Type of Medium: Online Resource
    ISSN: 1352-0504 , 1365-2893
    URL: Issue
    URL: Article
    DOI: 10.1111/jvh.v28.11
    DOI: 10.1111/jvh.13601
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2007924-2
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  • 6
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    Online Resource
    Long‐term renal safety between patients with chronic hepatitis B receiving tenofovir vs. entecavir therapy: A multicenter study
    Wiley ; 2022
    In:  Journal of Viral Hepatitis Vol. 29, No. 4 ( 2022-04), p. 289-296
    Details
    In: Journal of Viral Hepatitis, Wiley, Vol. 29, No. 4 ( 2022-04), p. 289-296
    Abstract: Renal safety is a critical issue in chronic hepatitis B (CHB) patients receiving long‐term entecavir (ETV) or tenofovir disofuroxil fumarate (TDF) therapy. We investigated their effects on estimated glomerular filtration rate (eGFR). Treatment‐naive CHB patients receiving ETV or TDF for ≥1 year were recruited. The eGFR was assessed using the Chronic Kidney Disease Epidemiology Collaboration equation. We calculated average annual percent change (AAPC) in eGFR using Joinpoint regression. At the beginning of the observation, the ETV group had more unfavorable conditions than the TDF group: lower eGFR and higher FIB‐4 and APRI than the TDF group (all p   〈  .001). After 6 years of antiviral therapy, the mean eGFR in the ETV group ( n  = 1793) was maintained (96.0 at first year to 95.6 ml/min/1.73 m 2 at sixth year; AAPC −0.09%; p  = .322), whereas that in the TDF group ( n  = 1240) significantly decreased annually (101.9 at first year to 96.9 ml/min/1.73 m 2 at sixth year; AAPC −0.88%; p   〈  .001). Notably, in the TDF group, even patients without diabetes (AAPC −0.80%; p  = 0.001) or hypertension (AAPC −0.87%; p  = .001) experienced significant decrease in eGFR. Expectably, accompanying diabetes (AAPC −1.59%; p  = .011) or hypertension (AAPC −1.00%; p  = .002) tended to accelerate eGFR decrease. TDF treatment (odds ratio 1.66, p   〈  .001), along with eGFR 〈 60 ml/min/1.73 m 2 , serum albumin 〈 3.5 mg/dl, and hypertension, were independently associated with ongoing renal dysfunction, defined as a negative slope of the mean eGFR change. In conclusion, compared with ETV, long‐term TDF treatment induced slow, but progressive renal dysfunction. Although the annual eGFR change by TDF was small, careful monitoring is necessary, especially in patients requiring life‐long therapy.
    Type of Medium: Online Resource
    ISSN: 1352-0504 , 1365-2893
    URL: Issue
    URL: Article
    DOI: 10.1111/jvh.v29.4
    DOI: 10.1111/jvh.13656
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2007924-2
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  • 7
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    Online Resource
    External validation of CAGE‐B and SAGE‐B scores for Asian chronic hepatitis B patients with well‐controlled viremia by antivirals
    Wiley ; 2021
    In:  Journal of Viral Hepatitis Vol. 28, No. 6 ( 2021-06), p. 951-958
    Details
    In: Journal of Viral Hepatitis, Wiley, Vol. 28, No. 6 ( 2021-06), p. 951-958
    Abstract: CAGE‐B and SAGE‐B scores, consisting of age and fibrotic burden as cirrhosis and/or liver stiffness, were recently proposed to predict hepatocellular carcinoma (HCC) risk among Caucasian chronic hepatitis B (CHB) patients undergoing long‐term antiviral therapy. We externally validated their predictive performances among an independent cohort from Asia, compared to other conventional prediction models. We consecutively recruited CHB patients with well‐controlled viremia (serum HBV DNA  〈  2000 IU/mL) receiving antiviral therapy. Patients with decompensated cirrhosis or HCC at baseline were excluded. Among 1763 patients, CAGE‐B score provided the highest Heagerty's integrated area under the curve (iAUC) (0.820), followed by SAGE‐B (0.804), mREACH‐B (0.800), CAMD (0.786), mPAGE‐B (0.748) and PAGE‐B (0.721) scores. CAGE‐B score showed a significantly better performance than SAGE‐B, CAMD, PAGE‐B and mPAGE‐B scores, but was similar to mREACH‐B. SAGE‐B score also showed significantly better performance than mPAGE‐B and PAGE‐B, but was similar to CAMD and mREACH‐B. According to CAGE‐B score 0–5, 6–10 and ≥11, the annual HCC incidences were 0.18, 1.34 and 6.03 per 100 person‐years, respectively (all p  〈  0.001 between each pair). Likewise, by SAGE‐B score 0–5, 6–10 and ≥11, those were 0.31, 1.49 and 8.96 per 100 person‐years, respectively (all p  〈  0.001 between each pair). Hence, CAGE‐B and SAGE‐B scores showed acceptable predictive performances for Asian CHB patients undergoing antiviral therapy, with the higher performance by CAGE‐B score. They show a trend towards better prognostic capability to predict HCC risk than previous models.
    Type of Medium: Online Resource
    ISSN: 1352-0504 , 1365-2893
    URL: Issue
    URL: Article
    DOI: 10.1111/jvh.v28.6
    DOI: 10.1111/jvh.13506
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2007924-2
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