@article{uoadl:3102832,
    volume = "15",
    number = "1",
    pages = "105-113",
    journal = "Hepatology International",
    issn = "1936-0533, 1936-0541",
    keywords = "antivirus agent;  entecavir;  nucleoside analog;  nucleotide derivative;  tenofovir disoproxil;  antivirus agent, adult;  age;  aged;  Article;  aspartate aminotransferase to platelet ratio index;  cancer incidence;  cancer risk;  Caucasian;  chronic hepatitis B;  clinical article;  digestive system disease assessment;  disease association;  disease severity;  female;  fibrosis 4 index;  follow up;  human;  liver cell carcinoma;  male;  non cirrhotic chronic hepatitis B;  non cirrhotic chronic hepatitis B;  outcome assessment;  PAGE B score;  platelet count;  priority journal;  prognostic assessment;  retrospective study;  risk assessment;  sex difference;  treatment duration;  virus load;  complication;  liver cell carcinoma;  liver cirrhosis;  liver tumor, Antiviral Agents;  Carcinoma, Hepatocellular;  Female;  Hepatitis B, Chronic;  Humans;  Liver Cirrhosis;  Liver Neoplasms;  Retrospective Studies",
    BIBTEX_ENTRY = "article",
    year = "2021",
    author = "Tseng, T.-C. and Choi, J. and Nguyen, M.H. and Peng, C.-Y. and Siakavellas, S. and Papatheodoridis, G. and Wang, C.-C. and Lim, Y.-S. and Lai, H.-C. and Trinh, H.N. and Wong, C. and Wong, C. and Zhang, J. and Li, J. and Kao, J.-H.",
    abstract = "Background and aims: Fibrosis-4 (FIB-4) index is a HCC predictor in chronic hepatitis B (CHB) patients. However, little is known about whether FIB-4 helps identify non-cirrhotic CHB patients with minimal HCC risk after prolonged nucleos(t)ide analogue (NA) therapy. Methods: A total of 1936 ethnically diverse, non-cirrhotic CHB patients were enrolled in this retrospective multi-national study. All patients received prolonged NA treatment, including entecavir and tenofovir disoproxil fumarate. We explored whether FIB-4 cutoff of 1.30, a marker indicative of mild fibrosis severity, could stratify HCC risks in these patients. Results: A total of 48 patients developed HCC after a mean follow-up of 6.98 years. FIB-4 level at 1 year after treatment (1-year FIB-4) was shown to be associated with HCC development and was superior to pre-treatment FIB-4 value. When patients were stratified by 1-year FIB-4 of 1.30, the high FIB-4 group was at an increased HCC risk compared to the low FIB-4 group, with a hazard ratio of 4.87 (95% confidence interval: 2.48–9.55). Multivariable analysis showed that sex and 1-year FIB-4 were independent predictors, with none of the 314 female patients with low 1-year FIB-4 developing HCC. Finally, 1-year FIB-4 of 1.30 consistently stratified HCC risks in patients with low PAGE-B score, a score composed of baseline age, sex and platelet count, and the annual incidence rate of HCC was 0.11% in those with PAGE-B < 10 + 1-year FIB-4 < 1.30. Conclusions: In non-cirrhotic CHB patients receiving prolonged NA therapy, 1-year FIB-4 < 1.30 is useful for identifying those with minimal HCC risk by combining with female sex or low PAGE-B score. © 2021, Asian Pacific Association for the Study of the Liver.",
    title = "One-year Fibrosis-4 index helps identify minimal HCC risk in non-cirrhotic chronic hepatitis B patients with antiviral treatment",
    doi = "10.1007/S12072-020-10124-Z"
}