Universität zu Köln

Demir, Muenevver, Gruenewald, Friederike, Lang, Sonja, Schramm, Christoph, Bowe, Andrea, Mueck, Vera, Kuetting, Fabian, Goeser, Tobias and Steffen, Hans-Michael (2016). Elevated liver fibrosis index FIB-4 is not reliable for HCC risk stratification in predominantly non-Asian CHB patients. Medicine (Baltimore), 95 (38). PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1536-5964

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Abstract

We aimed to validate the liver fibrosis index FIB-4 as a model for risk stratification of hepatocellular carcinoma development in predominantly non-Asian patients with chronic hepatitis B infection seen at a tertiary referral center in Germany.We retrospectively analyzed 373 adult patients with chronic hepatitis B infection. Patient demographics, hepatitis B markers, antiviral treatment, laboratory parameters, results from liver imaging and histology were recorded. Patients were divided into 2 groups according to their FIB-4 levels and their hazard ratios for developing hepatocellular carcinoma were analyzed adjusted for age, sex, body mass index, alcohol consumption, and antiviral medication.Median follow-up was 8.7 years (range 1-21.3 years), 93% of patients were of non-Asian origin, and 64% were male. Compared with patients with a low FIB-4 (<1.25) patients with FIB-4 1.25 showed a hazard ratio for incidence of hepatocellular carcinoma of 3.03 (95% confidence interval (CI): 1.24-7.41) and an adjusted hazard ratio of 1.75 (95% CI: 0.64-4.74). Notably, 68% of patients with liver cirrhosis and 68% of those who developed HCC during observation had a low FIB-4 (<1.25).We could not confirm that a FIB-4 value 1.25 is a reliable clinical indicator for incidence of hepatocellular carcinoma in predominantly non-Asian patients with chronic hepatitis B. Further studies in geographically and ethnically diverse populations are needed to prove its utility as a predictive tool.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Demir, Muenevver UNSPECIFIED UNSPECIFIED UNSPECIFIED Gruenewald, Friederike UNSPECIFIED UNSPECIFIED UNSPECIFIED Lang, Sonja UNSPECIFIED UNSPECIFIED UNSPECIFIED Schramm, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Bowe, Andrea UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueck, Vera UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuetting, Fabian UNSPECIFIED UNSPECIFIED UNSPECIFIED Goeser, Tobias UNSPECIFIED UNSPECIFIED UNSPECIFIED Steffen, Hans-Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-263794
DOI:	10.1097/MD.0000000000004602
Journal or Publication Title:	Medicine (Baltimore)
Volume:	95
Number:	38
Date:	2016
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1536-5964
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CHRONIC HEPATITIS-B; HEPATOCELLULAR-CARCINOMA; SURVEILLANCE PROGRAM; CLINICAL MANAGEMENT; ENTECAVIR TREATMENT; NATURAL-HISTORY; VIRUS INFECTION; CIRRHOSIS; DIAGNOSIS; EPIDEMIOLOGY Multiple languages Medicine, General & Internal Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/26379