Universität zu Köln

Kuetting, Fabian, Lang, Sonja, Schramm, Christoph, Kasper, Philipp, Goeser, Tobias, Steffen, Hans-Michael and Demir, Muenevver (2019). FIB-4 Is a Potential Tool for Hepatocellular Carcinoma Risk Stratification in Ethnically Diverse Chronic Hepatitis B Patients When Using Specific Cutoff Values. Hepat. Mon., 19 (12). HOENSBROEK: KOWSAR PUBL. ISSN 1735-3408

Full text not available from this repository.

Abstract

Background: In a previous publication, a FIB-4 cutoff value of >= 1.25, which had been determined in an Asian population, did not allow reliable prediction of the development of hepatocellular carcinoma (HCC) in a patient collective with chronic hepatitis B (CHB) of predominantly non-Asian descent. Objectives: Here, we aimed to validate the modified FIB-4 cutoff values as a means of stratifying the HCC risk in a non-Asian cohort seen at an outpatient university hospital liver unit in Germany. Methods: We retrospectively analyzed 350 adult patients with CHB infection. We recorded demographics, laboratory parameters, results from liver imaging, serological hepatitis B markers, antiviral treatment, and histology. We separated patients into two groups based on individual FIB-4 levels. We, then, analyzed the patients' hazard ratios for HCC and adjusted it for sex, age, antiviral medication, duration of CHB infection, body mass index, alcohol consumption, and type 2 diabetes. An additional sub-analysis was performed by including only non-cirrhotic patients to determine the validity of the proposed cutoffs in that cohort. Results: The median duration of follow-up was 8.9 years with a range of 1- 21.3 years. Our patients were 65% males. In comparison with patients that had a low FIB-4 (< 0.3635), those with elevated FIB-4 (>= 0.3635) had an HCC incidence hazard ratio of 11.67 (95% confidence interval (CI): 2.73 - 49.96; P = 0.001) and an adjusted hazard ratio of 7.90 (95% CI: 1.58 - 39.39; P = 0.012). Elevated FIB-4 non-cirrhotic patients had a hazard ratio (HR) of 15.88 (95% CI: 2.04 - 123.20) for HCC incidence (P < 0.0001) and an adjusted HR of 11.99 (95% CI:1.36 -105.72) (P = 0.001). Conclusions: A FIB-4 value of < 0.3635 appears to be a clinical indicator for a low likelihood of HCC incidence in non-Asian patients with CHB with or without cirrhosis. Further studies in patients of diverse descent are necessary to prove its utility as a clinical tool in this setting.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Kuetting, Fabian UNSPECIFIED UNSPECIFIED UNSPECIFIED Lang, Sonja UNSPECIFIED UNSPECIFIED UNSPECIFIED Schramm, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Kasper, Philipp UNSPECIFIED UNSPECIFIED UNSPECIFIED Goeser, Tobias UNSPECIFIED UNSPECIFIED UNSPECIFIED Steffen, Hans-Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Demir, Muenevver UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-125189
DOI:	10.5812/hepatmon.94574
Journal or Publication Title:	Hepat. Mon.
Volume:	19
Number:	12
Date:	2019
Publisher:	KOWSAR PUBL
Place of Publication:	HOENSBROEK
ISSN:	1735-3408
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PRIMARY LIVER-CANCER; SURVEILLANCE PROGRAM; CLINICAL MANAGEMENT; ENTECAVIR TREATMENT; FIBROSIS; CIRRHOSIS; VIRUS; VALIDATION; DIAGNOSIS; INDEX Multiple languages Gastroenterology & Hepatology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/12518