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Risk stratification of hepatocellular carcinoma incidence using a fibrosis-4-based prediction model in patients with chronic hepatitis C receiving antiviral therapy: a nationwide real-world Taiwanese cohort study.


ABSTRACT: A total of 1,589 patients who had received interferon-based treatment were enrolled and analyzed for the risk of hepatocellular carcinoma (HCC) in a real-world nationwide Taiwanese chronic hepatitis C cohort (T-COACH). We aimed to stratify HCC risk by non-invasive fibrosis index-based risk model. Of 1589 patients, 1363 (85.8%) patients achieved sustained virological response (SVR). Patients with SVR had 1, 3, 5 and 10-year cumulative HCC incidence rates of 0.55%, 1.87%, 3.48% and 8.35%, respectively. A Cox proportional hazards model revealed that non-SVR (adjusted hazard ratio [aHR]: 1.92, 95% confidence interval [CI]: 1.19-3.12, p = 0.008), diabetes mellitus (aHR: 2.11, 95% CI: 1.25-3.55, p = 0.005), and fibrosis (FIB)-4 at the end of follow-up (EOF; aHR: 5.60, 95% CI: 2.97-10.57, p < 0.0001) were independent predictors of HCC. Risk score models based on the three predictors were developed to predict HCC according to aHR. In model 1, the 10-year cumulative incidence rates of HCC were 43.35% in patients at high risk (score 9-10), 25.48% in those at intermediate risk (score 6-8), and 4.06% in those at low risk (score 3-5) of HCC. In model 2, the 10-year cumulative incidence rates of HCC were 39.64% in patients at high risk (at least two risk predictors), 19.12% in those at intermediate risk (with one risk predictor), and 2.52% in those at low risk (without any risk predictors) of HCC. The FIB-4-based prediction model at EOF could help stratify the risk of HCC in patients with chronic hepatitis C after antiviral treatment.

SUBMITTER: Wang HW 

PROVIDER: S-EPMC9360245 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

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Risk stratification of hepatocellular carcinoma incidence using a fibrosis-4-based prediction model in patients with chronic hepatitis C receiving antiviral therapy: a nationwide real-world Taiwanese cohort study.

Wang Hung-Wei HW   Tsai Pei-Chein PC   Chen Chi-Yi CY   Tseng Kuo-Chih KC   Lai Hsueh-Chou HC   Kuo Hsing-Tao HT   Hung Chao-Hung CH   Tung Shui-Yi SY   Wang Jing-Houng JH   Chen Jyh-Jou JJ   Lee Pei-Lun PL   Chien Ron-Nan RN   Lin Chun-Yen CY   Yang Chi-Chieh CC   Lo Gin-Ho GH   Tai Chi-Ming CM   Lin Chih-Wen CW   Kao Jia-Horng JH   Liu Chun-Jen CJ   Liu Chen-Hua CH   Yan Sheng-Lei SL   Bair Ming-Jong MJ   Su Wei-Wen WW   Chu Cheng-Hsin CH   Chen Chih-Jen CJ   Lo Ching-Chu CC   Cheng Pin-Nan PN   Chiu Yen-Cheng YC   Wang Chia-Chi CC   Cheng Jin-Shiung JS   Tsai Wei-Lun WL   Lin Han-Chieh HC   Huang Yi-Hsiang YH   Huang Jee-Fu JF   Dai Chia-Yen CY   Chuang Wan-Long WL   Yu Ming-Lung ML   Peng Cheng-Yuan CY  

American journal of cancer research 20220715 7


A total of 1,589 patients who had received interferon-based treatment were enrolled and analyzed for the risk of hepatocellular carcinoma (HCC) in a real-world nationwide Taiwanese chronic hepatitis C cohort (T-COACH). We aimed to stratify HCC risk by non-invasive fibrosis index-based risk model. Of 1589 patients, 1363 (85.8%) patients achieved sustained virological response (SVR). Patients with SVR had 1, 3, 5 and 10-year cumulative HCC incidence rates of 0.55%, 1.87%, 3.48% and 8.35%, respecti  ...[more]

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