Clinical usefulness of noninvasive fibrosis indices for predicting hepatocellular carcinoma in treatment‐naïve patients with chronic hepatitis B following entecavir therapy. Issue 9 (19th July 2021)

• Record Type: Journal Article
• Authors: Jeong, Joonho; Shin, Jung Woo; Jung, Seok Won; Lee, Seung Bum; Park, Eun Ji; Park, Neung Hwa
• Is Part Of: Hepatology research. Volume 51:Issue 9(2021)
• Page Start: 923
• Page End: 932
• Publication Date: 2021-07-19
• Subjects: APRI -- chronic hepatitis B -- entecavir -- FIB‐4 -- hepatocellular carcinoma -- modified FIB‐4; Liver -- Diseases -- Periodicals; Liver Diseases -- Periodicals; Foie -- Maladies -- Périodiques; 616.362
• DOI: 10.1111/hepr.13690
• Languages: English
• ISSNs: 1386-6346

Abstract

Abstract: Aims: This study aimed to evaluate the clinical usefulness of the aminotransferase to platelet ratio index (APRI), fibrosis‐4 (FIB‐4), and modified FIB‐4 (mFIB‐4) indices in predicting hepatocellular carcinoma (HCC) in patients receiving entecavir (ETV) treatment. Methods: Among 1955 patients treated with ETV, a total of 857 treatment‐naive chronic hepatitis B patients (424 with liver cirrhosis [LC], 433 without cirrhosis) treated with ETV for more than 1 year were analyzed. Results: Of the 857 patients, 85 (9.9%) patients (77 in the LC group and 8 in the non‐LC group) developed HCC during the follow‐up period. The median observation period was 6.9 years. Multivariate regression analysis of HCC incidence revealed that the initial mFIB‐4 index (hazard ratio [HR] 1.058; 95% confidence interval [CI], 1.007–1.112; p = 0.027) and improvement in the FIB‐4 index after 1 year of ETV treatment (HR 0.531; 95% CI, 0.339–0.831; p = 0.006) were independent prognostic factors in the entire cohort. In the LC group, the improvement of the FIB‐4 index following ETV treatment (HR 0.491; 95% CI, 0.280–0.861; p = 0.013) was negatively correlated with incidence of HCC. However, the area under the receiver operating characteristic curve of specific cut‐off values of the FIB‐4 index at baseline and 1 year after ETV treatment were 0.572 (95% CI, 0.504–0.640) and 0.615 (95% CI, 0.546–0.684), respectively. In the non‐LC group, none of the invasive fibrosis indices could predict HCC incidence. Conclusions: The specific cut‐off value of the FIB‐4 index was not suitable for predicting HCC. However, the improvement in the FIB‐4 index after 1 year of ETV therapy could be a predictor of HCC development in cirrhotic patients.