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- Review Article Hepatocellular Carcinoma Prediction Models for Patients with Chronic Hepatitis B Virus Infection in the Era of Potent Antiviral Therapy
- Lee, Hye Won , Kim, Beom Kyung
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Journal of Liver Cancer 2018;18(2):87-93
DOI: https://doi.org/10.17998/jlc.18.2.87
Published online: September 30, 2018
2Yonsei Liver Center, Severance Hospital, Seoul, Korea.
3Institute of Gastroenterology, Yonsei University College of medicine, Seoul, Korea.
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Abstract
Appropriate prediction of hepatocellular carcinoma (HCC) development is of paramount importance in terms of decision on antiviral therapy and HCC surveillance. To date, many HCC risk prediction models had been derived based on well-known risk factors such as age, male gender, the degree of fibrosis, and serum hepatitis B virus (HBV)-DNA load. Overall, such models showed high negative predictive values of approximately >90%, excluding the possibility of HCC development in 3 to 10 years with considerable accuracy. On the other hands, on the basis that potent antiviral therapy can substantially reduce the risk of HCC, its indications are steadily getting expanded for prevention of disease progression. Since antiviral therapy is a very strong disease modifier, the uniform application of HCC risk scores developed before the era of potent antiviral therapy would overestimate the risk of HCC. Furthermore, the tools to assess the fibrotic burden have remarkably evolved, from subjective determination based upon clinical symptom sign and ultrasonographic finding to more objective and delicate non-invasive tests based upon imaging and/or serological methods. Therefore, in the current era of potent antiviral therapy, the clinical significance of recently developed HCC risk models for patients with chronic HBV infection should be reappraised further.
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