Impact of antiviral therapy on risk prediction model for hepatocellular carcinoma development in patients with chronic hepatitis B.

AIM: Risk prediction models for hepatocellular carcinoma (HCC) development are available. However, the influence of antiviral therapy (AVT) on these models in patients with chronic hepatitis B (CHB) is unknown.

METHODS: The dynamic changes in risk prediction models during AVT and the association between risk prediction model and the risk of CHB-related HCC development were investigated. Between 2005 and 2017, 4,917 patients with CHB (3,361 non-cirrhotic, 1,556 cirrhotic) were recruited.

RESULTS: The mean age of the study population was 49.3 years and 60.6% (n=2,980) of the patients were male. The mean Chinese University-HCC (CU-HCC) score was 12.7 at baseline in the overall study population, and decreased significantly (mean, 8.7) after 1 year of AVT (p<0.001). The score was maintained throughout 5 years of AVT (mean, 8.4-8.8; p>0.05). The proportion of high-risk patients (CU-HCC score ≥ 20) was 28.9% at baseline, and decreased significantly after 1 year of AVT (5.0%; p<0.001), and remained stable through 5 years of AVT (2.2-3.6%; p>0.05). In addition to the score at baseline, the CU-HCC score at 1 year of AVT independently predicted the risk of HCC development (hazard ratio=1.072; p<0.001), together with male gender and platelet count (all p<0.05).

CONCLUSIONS: The CU-HCC score significantly decreased at 1 year of AVT and was maintained thereafter. The CU-HCC score after 1 year of AVT independently predicted the risk of HCC development in patients with CHB.