Details

Autor(en) / Beteiligte

• Inoue, Jun
• Akahane, Takehiro
• Kobayashi, Tomoo
• Kimura, Osamu
• Sato, Kosuke
• Ninomiya, Masashi
• Iwata, Tomoaki
• Takai, Satoshi
• Kisara, Norihiro
• Sato, Toshihiro
• Nagasaki, Futoshi
• Miura, Masahito
• Nakamura, Takuya
• Umetsu, Teruyuki
• Sano, Akitoshi
• Tsuruoka, Mio
• Onuki, Masazumi
• Sawahashi, Satoko
• Niitsuma, Hirofumi
• Masamune, Atsushi

Titel

Usefulness of the Fibrosis‐4 index and alanine aminotransferase at 1 year of nucleos(t)ide analog treatment for prediction of hepatocellular carcinoma in chronic hepatitis B patients

Ist Teil von

• Hepatology research, 2024-02, Vol.54 (2), p.131-141

Ort / Verlag

Netherlands: Wiley Subscription Services, Inc

Erscheinungsjahr

2024

Quelle

Wiley Online Library

Beschreibungen/Notizen

• Aim Nucleos(t)ide analogs do not completely prevent hepatocellular carcinoma (HCC) in chronic hepatitis B virus infection. This study aimed to evaluate the dynamics of a non‐invasive liver fibrosis marker, the Fibrosis‐4 (FIB‐4) index, for predicting HCC development. Methods Among a total of 882 chronically hepatitis B virus infection‐infected patients who were treated with nucleos(t)ide analogs, 472 patients without HCC history whose FIB‐4 at baseline and 1 year of treatment was obtained were evaluated for the incidence of HCC. Results The median FIB‐4 was 2.00 at baseline and was significantly reduced to 1.58 at 1 year (P < 0.001), but the reduction was small at 2 years or later. When a receiver operating characteristic analysis of FIB‐4 was performed to predict HCC within 5 years, the area under the curve of FIB‐4 at 1 year was higher than that at baseline (0.676 vs. 0.599). The HCC incidence was significantly higher in patients with FIB‐4 ≥1.58 than in those with FIB‐4 <1.58 (14.8% vs. 3.6% at 10 years, P < 0.001). Additionally, an abnormal alanine aminotransferase (≥31 U/L) at 1 year was an independent risk for HCC. When a fibrosis and alanine aminotransferase‐1 (FAL‐1) score was evaluated as an applicable number of FIB‐4 ≥1.58, and alanine aminotransferase ≥31 as 0, 1, and 2, the HCC risk in patients with score 2 was significantly higher than in those with score 1 or score 0 (24.1% vs. 9.8% vs. 0.7% at 10 years, P < 0.001). Conclusions FIB‐4 ≥1.58 and alanine aminotransferase ≥31 at 1 year of nucleos(t)ide analog was an independent risk factor for HCC development, and a score using these factors stratified the risk of HCC. Nucleos(t)ide analog‐treated chronic hepatitis B patients with a higher Fibrosis‐4 index (≥1.58) at year 1 after the therapy showed a higher incidence of hepatocellular carcinoma. A fibrosis and alanine aminotransferase‐1 (FAL‐1) score that can be calculated simply with the Fibrosis‐4 index and alanine aminotransferase at year 1 of nucleos(t)ide analog might be useful to predict hepatocellular carcinoma development in the clinical settings.