Gut Liver.  2016 Nov;10(6):962-968. 10.5009/gnl15426.

Predictive Value of Antiviral Effects in the Development of Hepatocellular Carcinoma in the General Korean Population with Chronic Hepatitis B

• Shim JJ
• Oh IH
• Kim SB
• Kim JW
• Lee CK
• Jang JY
• Lee JS
• Kim BH

• KMID: 2412103
• DOI: http://doi.org/10.5009/gnl15426

Abstract

BACKGROUND/AIMS
The benefit of oral antiviral therapy in preventing hepatocellular carcinoma (HCC) in the general population is not well understood. We used a novel prediction method to estimate the risk of HCC in the Korean population based on various treatment guidelines.
METHODS
The 5-year risk of HCC following antiviral therapy was calculated using an HCC risk prediction model. A virtual cohort that represented Koreans (>40 years old) with chronic hepatitis B virus (HBV) infection was established using the fifth National Health and Nutrition Examination Survey. The antiviral indications tested were the Korean National Health Insurance (NHI) and European Association for the Study of the Liver (EASL) guidelines as well as a new extended indication (serum HBV DNA >2,000 IU/mL regardless of serum aminotransferase level).
RESULTS
A total of 993,872 subjects were infected with HBV in the general Korean population. Over a 5-year period, 2,725 HCC cases were predicted per 100,000 persons (0.55%/yr). When the cohort was treated based on the Korean NHI, the EASL, and the newly extended indications, HCC risks decreased to 2,531 (−7.1%), 2,089 (−23.3%), and 1,122 (−58.8%) cases per 100,000 persons, respectively (p<0.0001).
CONCLUSIONS
Simulated risk prediction suggests that extending of oral antiviral indication may reduce the HCC risk in the general population.

Keyword

Antiviral therapy; Hepatitis B, chronic; Carcinoma, hepatocellular

MeSH Terms

Adult
Antiviral Agents/*therapeutic use
Carcinoma, Hepatocellular/*virology
DNA, Viral/blood
Female
Hepatitis B virus/genetics
Hepatitis B, Chronic/complications/*drug therapy
Humans
Liver Neoplasms/*virology
Male
Middle Aged
Nutrition Surveys
Predictive Value of Tests
Republic of Korea
Risk Assessment/*methods
Risk Factors
Transaminases/blood
Antiviral Agents
DNA, Viral
Transaminases