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

Hung-Wei Wang, Pei-Chein Tsai, Chi-Yi Chen, Kuo-Chih Tseng, Hsueh-Chou Lai, Hsing-Tao Kuo, Chao-Hung Hung, Shui-Yi Tung, Jing-Houng Wang, Jyh-Jou Chen, Pei-Lun Lee, Ron-Nan Chien, Chun-Yen Lin, Chi-Chieh Yang, Gin-Ho Lo, Chi-Ming Tai, Chih-Wen Lin, Jia-Horng Kao, Chun-Jen Liu, Chen-Hua LiuSheng-Lei Yan, Ming-Jong Bair, Wei-Wen Su, Cheng-Hsin Chu, Chih-Jen Chen, Ching-Chu Lo, Pin-Nan Cheng, Yen-Cheng Chiu, Chia-Chi Wang, Jin-Shiung Cheng, Wei-Lun Tsai, Han-Chieh Lin, Yi-Hsiang Huang, Jee-Fu Huang, Chia-Yen Dai, Wan-Long Chuang, Ming-Lung Yu, Cheng-Yuan Peng

Research output: Contribution to journalJournal Article peer-review

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.
Original languageAmerican English
Pages (from-to)3164
JournalAmerican Journal of Cancer Research
Volume12
Issue number7
StatePublished - 2022

Keywords

  • Chronic hepatitis C
  • FIB-4
  • SIMPLE NONINVASIVE INDEX
  • SUSTAINED VIROLOGICAL RESPONSE
  • T-COACH
  • hepatocellular carcinoma

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