In:
Liver International, Wiley, Vol. 38, No. 1 ( 2018-01), p. 68-75
Kurzfassung:
We tested whether non‐invasive tests for liver disease severity can stratify hepatocellular carcinoma ( HCC ) risk in chronic hepatitis B virus ( HBV )‐infected patients showing low‐level viremia ( LLV , HBV DNA 〈 2000 IU / mL ). Methods A retrospective cohort of 1006 chronic hepatitis B patients showing persistently LLV , defined by at least two consecutive assessments in the year before enrolment, was assessed for HCC development. Two non‐invasive serum biomarkers, the aspartate aminotransferase to platelet ratio index ( APRI ) and the Fibrosis‐4 ( FIB ‐4), were tested. Cirrhosis was defined with ultrasonography. Results During a median 5.1 years of follow‐up, HCC developed in 36 patients. HCC incidence rate at 5 years was significantly higher for cirrhotic patients (19/139, 13.7%), but was not null for non‐cirrhotic patients (17/867, 2.0%, P 〈 .001). APRI at a cut‐off of 0.5 was more specific but less sensitive for HCC development, and FIB ‐4 at a cut‐off of 1.45 was more sensitive but less specific. When both APRI and FIB ‐4 were used to group patients, the 5‐year cumulative HCC incidence rate was 13.9%, 1.4% and 1.2% for both high, any high, and both low APRI and FIB ‐4 score among all patients (n=1006, P 〈 .001), respectively, and was 11.4%, 1.5% and 0.4% in the same respective order among non‐cirrhotic patients (n=867, P 〈 .001). Conclusions The combined use of two non‐invasive serum biomarkers ( APRI and FIB ‐4) could stratify HCC risk for chronic HBV ‐infected patients with LLV .
Materialart:
Online-Ressource
ISSN:
1478-3223
,
1478-3231
DOI:
10.1111/liv.2018.38.issue-1
Sprache:
Englisch
Verlag:
Wiley
Publikationsdatum:
2018
ZDB Id:
2124684-1
