Predictive Value of Antiviral Effects in the Development of Hepatocellular Carcinoma in the General Korean Population with Chronic Hepatitis B.
OBJECTIVE
The benefit of oral antiviral therapy in preventing hepatocellular carcinoma (HCC) in the general population is not well understood. We used a novel prediction method to estimate the risk of HCC in the Korean population based on various treatment guidelines.


METHODS
The 5-year risk of HCC following antiviral therapy was calculated using an HCC risk prediction model. A virtual cohort that represented Koreans (>40 years old) with chronic hepatitis B virus (HBV) infection was established using the fifth National Health and Nutrition Examination Survey. The antiviral indications tested were the Korean National Health Insurance (NHI) and European Association for the Study of the Liver (EASL) guidelines as well as a new extended indication (serum HBV DNA >2,000 IU/mL regardless of serum aminotransferase level).


RESULTS
A total of 993,872 subjects were infected with HBV in the general Korean population. Over a 5-year period, 2,725 HCC cases were predicted per 100,000 persons (0.55%/yr). When the cohort was treated based on the Korean NHI, the EASL, and the newly extended indications, HCC risks decreased to 2,531 (-7.1%), 2,089 (-23.3%), and 1,122 (-58.8%) cases per 100,000 persons, respectively (p<0.0001).


CONCLUSIONS
Simulated risk prediction suggests that extending of oral antiviral indication may reduce the HCC risk in the general population.
Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea.
Jae-Jun
JJ
Shim
Department of Preventive Medicine, Kyung Hee University School of Medicine, Seoul, Korea.
In Hwan
IH
Oh
Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA.
Sang Bae
SB
Kim
Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea.
Jung Wook
JW
Kim
Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea.
Chang Kyun
CK
Lee
Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea.
Jae Young
JY
Jang
Department of Systems Biology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Ju-Seog
JS
Lee
Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea.
Byung-Ho
BH
Kim
D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000821:virology*; D004279:DNA, Viral / Q000097:blood; D005260:Female; D006515:Hepatitis B virus / Q000235:genetics; D019694:Hepatitis B, Chronic / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008113:Liver Neoplasms / Q000821:virology*; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D011237:Predictive Value of Tests; D056910:Republic of Korea; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D000637:Transaminases / Q000097:blood
D000998:Antiviral Agents; D004279:DNA, Viral; D000637:Transaminases
Antiviral therapy; Carcinoma, hepatocellular; Hepatitis B, chronic