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REAL-B (Real-world Effectiveness from the Asia Pacific Rim Liver Consortium for HBV) Risk Score for the Prediction of Hepatocellular Carcinoma in Chronic Hepatitis B Patients Treated with Oral Antiviral Therapy.

REAL-B (Real-world Effectiveness from the Asia Pacific Rim Liver Consortium for HBV) Risk Score for the Prediction of Hepatocellular Carcinoma in Chronic Hepatitis B Patients Treated with Oral Antiviral Therapy. The Journal of infectious diseases Yang, H. I., Yeh, M. L., Wong, G. L., Peng, C. Y., Chen, C. H., Trinh, H. N., Cheung, K. S., Xie, Q. n., Su, T. H., Kozuka, R. n., Lee, D. H., Ogawa, E. n., Zhao, C. n., Ning, H. B., Huang, R. n., Li, J. n., Zhang, J. Q., Ide, T. n., Xing, H. n., Iwane, S. n., Takahashi, H. n., Wong, C. n., Wong, C. n., Lin, C. H., Hoang, J. n., le, A. n., Henry, L. n., Toyoda, H. n., Ueno, Y. n., Gane, E. J., Eguchi, Y. n., Kurosaki, M. n., Wu, C. n., Liu, C. n., Shang, J. n., Furusyo, N. n., Enomoto, M. n., Kao, J. H., Yuen, M. F., Yu, M. L., Nguyen, M. H. 2019

Abstract

Patients on oral antiviral (OAV) therapy remain at HCC risk. Risk prediction tools distinguishing treated patients with residual HCC risk are limited. Aim: Develop an accurate, precise, simple-to-use HCC risk score using routine clinical variables among a treated Asian cohort.Routine practice adult Asian CHB patients on OAV were recruited from 25 centers in the US and Asia-Pacific region. Excluded persons were co-infected with hepatitis C, D, or HIV, had HCC prior to or within 1 year of study entry or their follow-up was <1 year. Patients were randomized to derivation and validation cohorts on a 2:1 ratio. Statistically significant predictors from multivariate modeling formed the REAL-B score.A total of 8,048 patients were randomized to the derivation (n=5,365) or validation group (n=2,683).The REAL-B model included 7 variables (male gender, age, alcohol use, diabetes, baseline cirrhosis, platelet count, and AFP) scores were categorized as: 0-3 low risk, 4-7 moderate risk, and 8-13 high risk. AUROCs were >0.80 for HCC risk at 3, 5, and 10 years, and were significantly higher than other risk models (p<0·001).The REAL-B score provides three distinct risk categories for HCC development in Asian CHB patients on OAV guiding HCC surveillance strategy.

View details for DOI 10.1093/infdis/jiz477

View details for PubMedID 31550363