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Non-Achievement of Alanine Aminotransferase Normalization Associated with the Risk of Hepatocellular Carcinoma during Nucleos(t)ide Analogue Therapies: A Multicenter Retrospective Study
Patients with a chronic hepatitis B virus (HBV) infection who are treated with nucleos(t)ide analogues (NAs) are still at risk for hepatocellular carcinoma (HCC), and it has been clinically questioned whether patients with a high risk of HCC can be identified efficiently. We aimed to clarify the ris...
Autores principales: | , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9101732/ https://www.ncbi.nlm.nih.gov/pubmed/35566481 http://dx.doi.org/10.3390/jcm11092354 |
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author | Inoue, Jun Kobayashi, Tomoo Akahane, Takehiro Kimura, Osamu Sato, Kosuke Ninomiya, Masashi Iwata, Tomoaki Takai, Satoshi Kisara, Norihiro Sato, Toshihiro Nagasaki, Futoshi Miura, Masahito Nakamura, Takuya Umetsu, Teruyuki Sano, Akitoshi Tsuruoka, Mio Onuki, Masazumi Niitsuma, Hirofumi Masamune, Atsushi |
author_facet | Inoue, Jun Kobayashi, Tomoo Akahane, Takehiro Kimura, Osamu Sato, Kosuke Ninomiya, Masashi Iwata, Tomoaki Takai, Satoshi Kisara, Norihiro Sato, Toshihiro Nagasaki, Futoshi Miura, Masahito Nakamura, Takuya Umetsu, Teruyuki Sano, Akitoshi Tsuruoka, Mio Onuki, Masazumi Niitsuma, Hirofumi Masamune, Atsushi |
author_sort | Inoue, Jun |
collection | PubMed |
description | Patients with a chronic hepatitis B virus (HBV) infection who are treated with nucleos(t)ide analogues (NAs) are still at risk for hepatocellular carcinoma (HCC), and it has been clinically questioned whether patients with a high risk of HCC can be identified efficiently. We aimed to clarify the risk factors associated with the development of HCC during NA therapies. A total of 611 chronically HBV-infected patients without a history of HCC, who were treated with NAs for more than 6 months (median 72 months), from 2000 to 2021, were included from 16 hospitals in the Tohoku district in Japan. Incidences of HCC occurrence were analyzed with clinical factors, including on-treatment responses. Alanine aminotransferase (ALT) normalization, based on the criteria of three guidelines, was analyzed with other parameters, including the age–male–ALBI–platelets (aMAP) risk score. During the observation period, 48 patients developed HCC, and the cumulative HCC incidence was 10.6% at 10 years. Non-achievement of ALT normalization at 1 year of therapy was mostly associated with HCC development when ALT ≤ 30 U/L was used as the cut-off (cumulative incidence, 19.9% vs. 5.3% at 10 years, p < 0.001). The effectiveness of the aMAP risk score at the start of treatment was validated in this cohort. A combination of an aMAP risk score ≥ 50 and non-achievement of ALT normalization could stratify the risk of HCC significantly, and notably, there was no HCC development in 103 patients without these 2 factors. In conclusion, non-achievement of ALT normalization (≤30 U/L) at 1 year might be useful in predicting HCC during NA therapies and, in combination with the aMAP risk score, could stratify the risk more precisely. |
format | Online Article Text |
id | pubmed-9101732 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-91017322022-05-14 Non-Achievement of Alanine Aminotransferase Normalization Associated with the Risk of Hepatocellular Carcinoma during Nucleos(t)ide Analogue Therapies: A Multicenter Retrospective Study Inoue, Jun Kobayashi, Tomoo Akahane, Takehiro Kimura, Osamu Sato, Kosuke Ninomiya, Masashi Iwata, Tomoaki Takai, Satoshi Kisara, Norihiro Sato, Toshihiro Nagasaki, Futoshi Miura, Masahito Nakamura, Takuya Umetsu, Teruyuki Sano, Akitoshi Tsuruoka, Mio Onuki, Masazumi Niitsuma, Hirofumi Masamune, Atsushi J Clin Med Article Patients with a chronic hepatitis B virus (HBV) infection who are treated with nucleos(t)ide analogues (NAs) are still at risk for hepatocellular carcinoma (HCC), and it has been clinically questioned whether patients with a high risk of HCC can be identified efficiently. We aimed to clarify the risk factors associated with the development of HCC during NA therapies. A total of 611 chronically HBV-infected patients without a history of HCC, who were treated with NAs for more than 6 months (median 72 months), from 2000 to 2021, were included from 16 hospitals in the Tohoku district in Japan. Incidences of HCC occurrence were analyzed with clinical factors, including on-treatment responses. Alanine aminotransferase (ALT) normalization, based on the criteria of three guidelines, was analyzed with other parameters, including the age–male–ALBI–platelets (aMAP) risk score. During the observation period, 48 patients developed HCC, and the cumulative HCC incidence was 10.6% at 10 years. Non-achievement of ALT normalization at 1 year of therapy was mostly associated with HCC development when ALT ≤ 30 U/L was used as the cut-off (cumulative incidence, 19.9% vs. 5.3% at 10 years, p < 0.001). The effectiveness of the aMAP risk score at the start of treatment was validated in this cohort. A combination of an aMAP risk score ≥ 50 and non-achievement of ALT normalization could stratify the risk of HCC significantly, and notably, there was no HCC development in 103 patients without these 2 factors. In conclusion, non-achievement of ALT normalization (≤30 U/L) at 1 year might be useful in predicting HCC during NA therapies and, in combination with the aMAP risk score, could stratify the risk more precisely. MDPI 2022-04-22 /pmc/articles/PMC9101732/ /pubmed/35566481 http://dx.doi.org/10.3390/jcm11092354 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Inoue, Jun Kobayashi, Tomoo Akahane, Takehiro Kimura, Osamu Sato, Kosuke Ninomiya, Masashi Iwata, Tomoaki Takai, Satoshi Kisara, Norihiro Sato, Toshihiro Nagasaki, Futoshi Miura, Masahito Nakamura, Takuya Umetsu, Teruyuki Sano, Akitoshi Tsuruoka, Mio Onuki, Masazumi Niitsuma, Hirofumi Masamune, Atsushi Non-Achievement of Alanine Aminotransferase Normalization Associated with the Risk of Hepatocellular Carcinoma during Nucleos(t)ide Analogue Therapies: A Multicenter Retrospective Study |
title | Non-Achievement of Alanine Aminotransferase Normalization Associated with the Risk of Hepatocellular Carcinoma during Nucleos(t)ide Analogue Therapies: A Multicenter Retrospective Study |
title_full | Non-Achievement of Alanine Aminotransferase Normalization Associated with the Risk of Hepatocellular Carcinoma during Nucleos(t)ide Analogue Therapies: A Multicenter Retrospective Study |
title_fullStr | Non-Achievement of Alanine Aminotransferase Normalization Associated with the Risk of Hepatocellular Carcinoma during Nucleos(t)ide Analogue Therapies: A Multicenter Retrospective Study |
title_full_unstemmed | Non-Achievement of Alanine Aminotransferase Normalization Associated with the Risk of Hepatocellular Carcinoma during Nucleos(t)ide Analogue Therapies: A Multicenter Retrospective Study |
title_short | Non-Achievement of Alanine Aminotransferase Normalization Associated with the Risk of Hepatocellular Carcinoma during Nucleos(t)ide Analogue Therapies: A Multicenter Retrospective Study |
title_sort | non-achievement of alanine aminotransferase normalization associated with the risk of hepatocellular carcinoma during nucleos(t)ide analogue therapies: a multicenter retrospective study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9101732/ https://www.ncbi.nlm.nih.gov/pubmed/35566481 http://dx.doi.org/10.3390/jcm11092354 |
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