Prediction of Hepatocellular Carcinoma and Liver-related Events in Anti-hepatitis D Virus-positive Individuals.

Autor:	Patmore LA; Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands. Electronic address: l.patmore@erasmusmc.nl., Spaan M; Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands., Agarwal K; Institute of Liver Studies, King's College Hospital London, United Kingdom., Koc ÖM; Department of Gastroenterology and Hepatology, Maastricht University Medical Center, Maastricht, The Netherlands., Blokzijl H; Department of Gastroenterology and Hepatology, University Medical Center Groningen, University of Groningen, The Netherlands., Brouwer S; Department of Gastroenterology and Hepatology, Haga Hospital, The Hague, The Netherlands., van Soest H; Department of Gastroenterology and Hepatology, Haaglanden Medical Center, The Hague, The Netherlands., van Hulzen AGW; Department of Internal Medicine and Infectious Diseases, Isala, Zwolle, The Netherlands., Janssen HLA; Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands., Lammers AJJ; Department of Internal Medicine and Infectious Diseases, Isala, Zwolle, The Netherlands., Jansen L; Department of Gastroenterology and Hepatology, OLVG, Amsterdam, The Netherlands., Claassen M; Department of Internal Medicine and Infectious Disease, Rijnstate Hospital, Arnhem, The Netherlands., de Man RA; Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands., Takkenberg RB; Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, Amsterdam, The Netherlands., van Dijk R; Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands., Posthouwer D; Department of Internal medicine and Medical Microbiology, Maastricht University Medical Center, Maastricht, The Netherlands., Reijnders JGP; Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; Department of Gastroenterology and Hepatology, Haga Hospital, The Hague, The Netherlands., Carey I; Institute of Liver Studies, King's College Hospital London, United Kingdom., Sonneveld MJ; Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
Jazyk:	angličtina
Zdroj:	Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association [Clin Gastroenterol Hepatol] 2024 Oct 09. Date of Electronic Publication: 2024 Oct 09.
DOI:	10.1016/j.cgh.2024.08.036
Abstrakt:	Background & Aims: Chronic hepatitis D (CHD) is the most severe form of chronic viral hepatitis, with a high risk of developing hepatocellular carcinoma (HCC) and liver-related mortality. Risk stratification is needed to guide HCC surveillance strategies and to prioritize treatment with antiviral agents. Methods: We conducted a multicenter retrospective cohort of anti-hepatitis D virus (HDV)-positive individuals managed at sites in the Netherlands and the United Kingdom. We studied the 5-year cumulative incidences of HCC and liver-related events (first of HCC, liver transplantation, and liver-related mortality), in the overall cohort and among relevant subgroups. Results: We analyzed 269 anti-HDV-positive individuals with a median follow-up of 4.3 years in which 47 first events occurred. The 5-year cumulative incidences of HCC and liver-related events were 3.8% and 15.6% in the overall cohort. The 5-year cumulative incidence of HCC and liver-related events for individuals without cirrhosis was 0% and 0.9% compared with 12% and 41.3% for individuals with cirrhosis (P < .001). The 5-year cumulative incidence of HCC and liver-related events was 0% and 2.1% among individuals with low PAGE-B scores, compared to 3.2% and 21.1% with intermediate and 25.4% and 45.5% with high-risk scores (P < .001). We found comparable results for the Fibrosis-4 score. Findings were consistent regardless of cirrhosis or detectable HDV RNA (P < .001). Conclusion: Anti-HDV-positive individuals are at high risk of adverse liver-related outcomes. The incidence of HCC was negligible among individuals without cirrhosis and among individuals with low baseline PAGE-B and/or Fibrosis-4 scores. Therefore, these scores can be used to guide HCC surveillance strategies and potentially also for treatment prioritization. (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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