Validation of PAGE-B model in Asian chronic hepatitis B patients receiving entecavir or tenofovir

Liver Int. 2017 Dec;37(12):1788-1795. doi: 10.1111/liv.13450. Epub 2017 May 12.

Abstract

Background & aims: A new hepatocellular carcinoma risk prediction model, PAGE-B, which includes age, gender and platelet count as constituent variables, has recently been proposed in Caucasian chronic hepatitis B patients. We validated PAGE-B model and compared its accuracy with that of conventional risk prediction models in Asian chronic hepatitis B patients.

Methods: Chronic hepatitis B patients treated with entecavir or tenofovir were consecutively recruited. The performance of PAGE-B and three conventional risk prediction models (CU-HCC, GAG-HCC and REACH-B) were analysed.

Results: A total of 1092 chronic hepatitis B patients (668 men, 61.2%) were selected between August 2006 and January 2015. The mean age was 48 years. During the follow-up period (median, 43.6 months), 36 (3.3%) patients developed hepatocellular carcinoma. Older age (hazard ratio [HR]=1.077), male gender (HR=3.676) and lower platelet count (HR=0.984) were independent predictors of hepatocellular carcinoma development. The PAGE-B showed similar area under receiver operating characteristic curves (AUROCs) to GAG-HCC and CU-HCC at 3 years (0.777 vs 0.793 and 0.743, respectively; all P>.05) and 5 years (0.799 vs 0.803 and 0.744, respectively; all P>.05), whereas the AUROCs of PAGE-B were significantly higher than those of the REACH-B (0.602 at 3 years and 0.572 at 5 years, P<.05).

Conclusions: Our study demonstrated that PAGE-B is applicable to Asian chronic hepatitis B patients receiving ETV or TDF therapy. The PAGE-B showed similar predictive performance to GAG-HCC and CU-HCC.

Keywords: PAGE-B; chronic hepatitis B; hepatocellular carcinoma; risk prediction model.

Publication types

  • Validation Study

MeSH terms

  • Adult
  • Antiviral Agents / therapeutic use*
  • Asian People
  • Carcinoma, Hepatocellular / ethnology
  • Carcinoma, Hepatocellular / virology*
  • Cohort Studies
  • Female
  • Guanine / analogs & derivatives
  • Guanine / therapeutic use
  • Hepatitis B, Chronic / complications*
  • Hepatitis B, Chronic / drug therapy
  • Humans
  • Liver Neoplasms / ethnology
  • Liver Neoplasms / virology*
  • Male
  • Middle Aged
  • Models, Theoretical*
  • Risk Assessment
  • Tenofovir / therapeutic use

Substances

  • Antiviral Agents
  • entecavir
  • Guanine
  • Tenofovir