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. 2022 Oct 18:9:1093-1104.
doi: 10.2147/JHC.S372571. eCollection 2022.

Incidence of Hepatocellular Carcinoma and Decompensated Liver Cirrhosis and Prognostic Accuracy of the PAGE-B HCC Risk Score in a Low Endemic Hepatitis B Virus Infected Population

Signe Bollerup  1 , Frederik Engsig  1 , Sofie Hallager  1 , Amanda Mocroft  2   3 , Birgit T Roege  4 , Peer B Christensen  5   6 , Alex L Laursen  7 , Henrik Krarup  8   9 , Mette R Clausen  10 , Peter Thielsen  11 , Lone G Madsen  12   13 , Lars Noerregaard  14 , Toke S Barfod  15 , Ulla Balslev  16 , Britta Tarp  17 , Jesper B Hansen  9 , Lone H Mygind  18 , Jan Gerstoft  13   19 , Nina Weis  1   13
Affiliations

Incidence of Hepatocellular Carcinoma and Decompensated Liver Cirrhosis and Prognostic Accuracy of the PAGE-B HCC Risk Score in a Low Endemic Hepatitis B Virus Infected Population

Signe Bollerup et al. J Hepatocell Carcinoma. .

Abstract

Purpose: We aimed to determine incidence of hepatocellular carcinoma (HCC) and decompensated liver cirrhosis in persons with chronic hepatitis B virus (HBV) infection in Denmark stratified by disease phase, liver cirrhosis, and treatment status at baseline. Additionally, we aimed to assess the prognostic value of the PAGE-B HCC risk score in a mainly non-cirrhotic population.

Patients and methods: In this register-based cohort study, we included all individuals over the age of 18, with chronic HBV infection first registered between 2002 and 2016 in at least one of three nationwide registers. The study population was followed until HCC, decompensated liver cirrhosis, death, emigration, or December 31, 2017, which ever came first.

Results: Among 6016 individuals included in the study, 10 individuals with and 23 without baseline liver cirrhosis developed HCC during a median follow up of 7.3 years (range 0.0-15.5). This corresponded to five-year cumulative incidences of 7.1% (95% confidence interval (CI) 2.0-12.3) and 0.2% (95% CI 0.1-0.4) in persons with and without baseline liver cirrhosis. The five-year cumulative incidence of decompensated liver cirrhosis was 0.7% (95% CI 0.5-1.0). Among 2038 evaluated for liver events stratified by disease phase, incidence of HCC was low in all who were non-cirrhotic and untreated for HBV at baseline. PAGE-B score was evaluated in 1529 persons. The 5-year cumulative incidence of HCC was 0, 0.8 (95% CI 0.5-1.8), and 8.7 (95% CI 1.0-16.4) in persons scoring <10, 10-17 and >17, respectively (c-statistic 0.91 (95% CI 0.84-0.98)).

Conclusion: We found low incidence of HCC and decompensated liver cirrhosis in persons with chronic HBV infection in Denmark. Moreover, the PAGE-B score showed good accuracy for five-year risk of developing HCC in the population with chronic HBV infection in Denmark.

Keywords: Scandinavia; hepatitis B virus; morbidity; nationwide; viral hepatitis.

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Conflict of interest statement

Signe Bollerup (SB) received financial support for conference participation from Abbvie, Gilead and MSD. Frederik Neess Engsig (FNE) reports lecture fee from MSD, not related to this study. Amanda Mocroft (AM) reports lecture fees, honoraria or consultancy fees from Gilead, ViiV, and Eiland and Bonnin, not related to this study. Peer B Christensen (PBC) reports grants from Abbvie, Gilead and MSD. None were related to this study. Alex Laursen (AL) received grants from Abbvie and Gilead, not related to this study. Nina Weis (NW) reports grands from Abbvie, Gilead and Novo Nordisk Foundation, not related to this study. Moreover, NW has been clinical investigator, lecturer or member of advisory boards for Abbvie, Gilead, GSK and MSD. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Selection of the study population.
Figure 2
Figure 2
Cumulative incidence of hepatocellular carcinoma in individuals with chronic hepatitis B virus infection in Denmark stratified by baseline liver cirrhosis status.
Figure 3
Figure 3
Cumulative incidence of decompensated liver cirrhosis in individuals with chronic hepatitis B virus infection in Denmark.
Figure 4
Figure 4
Cumulative incidence of hepatocellular carcinoma or liver events individuals with chronic hepatitis B virus infection in Denmark stratified by baseline PAGE-B score. PAGE-B score categories are <10, 10–17 and >17.
See this image and copyright information in PMC

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