J Liver Cancer.  2018 Sep;18(2):87-93. 10.17998/jlc.18.2.87.

Hepatocellular Carcinoma Prediction Models for Patients with Chronic Hepatitis B Virus Infection in the Era of Potent Antiviral Therapy

• Lee HW
• Kim BK

• KMID: 2422620
• DOI: http://doi.org/10.17998/jlc.18.2.87

Abstract

Appropriate prediction of hepatocellular carcinoma (HCC) development is of paramount importance in terms of decision on antiviral therapy and HCC surveillance. To date, many HCC risk prediction models had been derived based on well-known risk factors such as age, male gender, the degree of fibrosis, and serum hepatitis B virus (HBV)-DNA load. Overall, such models showed high negative predictive values of approximately >90%, excluding the possibility of HCC development in 3 to 10 years with considerable accuracy. On the other hands, on the basis that potent antiviral therapy can substantially reduce the risk of HCC, its indications are steadily getting expanded for prevention of disease progression. Since antiviral therapy is a very strong disease modifier, the uniform application of HCC risk scores developed before the era of potent antiviral therapy would overestimate the risk of HCC. Furthermore, the tools to assess the fibrotic burden have remarkably evolved, from subjective determination based upon clinical symptom sign and ultrasonographic finding to more objective and delicate non-invasive tests based upon imaging and/or serological methods. Therefore, in the current era of potent antiviral therapy, the clinical significance of recently developed HCC risk models for patients with chronic HBV infection should be reappraised further.

Keyword

Carcinoma, Hepatocellular; Prediction; Hepatitis B virus; Antiviral therapy

MeSH Terms

Carcinoma, Hepatocellular*
Clothing
Disease Progression
Fibrosis
Hand
Hepatitis B virus
Hepatitis B, Chronic*
Hepatitis, Chronic*
Humans
Male
Risk Factors