Assessment of HCC Risk in Patients with Chronic HBV (REACH, PAGE-B, and Beyond)

  • PDF / 418,297 Bytes
  • 8 Pages / 595.276 x 790.866 pts Page_size
  • 14 Downloads / 151 Views

DOWNLOAD

REPORT


HEPATITIS B (JK LIM, SECTION EDITOR)

Assessment of HCC Risk in Patients with Chronic HBV (REACH, PAGE-B, and Beyond) Terry Cheuk-Fung Yip 1,2,3 & Lilian Yan Liang 1,2 & Grace Lai-Hung Wong 1,2,3

# Springer Science+Business Media, LLC, part of Springer Nature 2020

Abstract Purpose of Review To provide an updated overview on the current status of risk prediction scores for hepatocellular carcinoma (HCC) in patients with chronic hepatitis B virus infection. Recent Findings More HCC risk scores have been developed, validated, and optimized (e.g., with liver stiffness measurement) in different patient and ethnic groups. Risk scores for treated patients with high negative predictive values would be able to identify patients who may not need HCC surveillance anymore as their HCC risk has been reduced by antiviral therapy. Summary Current HCC risk scores can accurately predict HCC in specific populations, in both treatment-naive patients and those receiving antiviral therapy. Different levels of care and different intensities of HCC surveillance should be offered according to the risk profile of patients. Keywords Cirrhosis . Hepatitis B virus . Hepatocellular carcinoma . Liver stiffness measurement . Prediction models

Abbreviations CDARS Clinical Data Analysis and Reporting System CHB Chronic hepatitis B CI Confidence intervals ETV Entecavir HBV Hepatitis B virus HCC Hepatocellular carcinoma I C D - 9 -International Classification of Diseases, Ninth CM Revision, Clinical Modification IQR Interquartile range LSM Liver stiffness measurement NA Nucleos(t)ide analogues TDF Tenofovir disoproxil fumarate

This article is part of the Topical Collection on Hepatitis B * Grace Lai-Hung Wong [email protected] 1

Institute of Digestive Disease, Hong Kong, SAR, China

2

Department of Medicine and Therapeutics, Prince of Wales Hospital, 9/F Lui Che Woo Clinical Sciences Building, 30-32 Ngan Shing Street, Shatin, Hong Kong

3

Medical Data Analytic Centre (MDAC), The Chinese University of Hong Kong, Hong Kong, SAR, China

Introduction Tremendous progress has been made in our understanding of chronic hepatitis B virus (HBV) infection and in its prevention and treatment in the last few decades; however, the global burden of HBV infection remains high. Expanding coverage of universal HBV vaccine and improving diagnosis and linkage to care are essential to meet the World Health Organization goal of eliminating HBV infection by 2030, a strategy that contributes to the proposed targets for the reduction of chronic viral hepatitis incidence and mortality of 80% and 65%, respectively [1]. In order to achieve a reduction of chronic viral hepatitis mortality of 65%, focused effort is of top priority to prevent deaths from the complications of chronic HBV infection. Hepatocellular carcinoma (HCC) is the fifth most common cancer in men and ninth most common in women worldwide [2]. HCC is one of the top killers as it carries a high mortality rate and represents the third most frequent cause of cancer death globally (782,000 deaths in 201