• Hye Yeon Chon, Yeon Seok Seo, Jung Il Lee, Byung Seok Kim, Byoung Kuk Jang, Sang Gyune Kim, Ki Tae Suk, In Hee Kim, Jin-Woo Lee, Young Eun Chon, Moon Young Kim, Soung Won Jeong, Han Ah Lee, Sun Young Yim, Soon Ho Um, LeeHyun WoongHWDepartment of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine., Kwan Sik Lee, Jeong Eun Song, Chang Hyeong Lee, Woo Jin Chung, Jae Seok Hwang, Jeong-Ju Yoo, Young Seok Kim, Dong Joon Kim, Chang Hun Lee, Jung Hwan Yu, Yeon Jung Ha, Mi Na Kim, Joo Ho Lee, Seong Gyu Hwang, Seong Hee Kang, Soon Koo Baik, Jae Young Jang, Sang Jun Suh, Young Kul Jung, Beom Kyung Kim, Jun Yong Park, KimDo YoungDYDepartment of Internal Medicine, Yonsei University College of Medicine., Sang Hoon Ahn, Kwang-Hyub Han, Hyung Joon Yim, Seung Up Kim, and Korean Transient Elastography Study Group.
• Department of Internal Medicine, Yonsei University College of Medicine.
• Eur J Gastroenterol Hepatol. 2021 Jun 1; 33 (6): 885-893.

ObjectiveThe liver stiffness-based risk prediction models predict hepatocellular carcinoma (HCC) development. We investigated the influence of antiviral therapy (AVT) on liver stiffness-based risk prediction model in patients with chronic hepatitis B (CHB).MethodsPatients with CHB who initiated AVT were retrospectively recruited from 13 referral Korean institutes. The modified risk estimation for hepatocellular carcinoma in chronic hepatitis B (mREACH-B) model was selected for the analysis.ResultsBetween 2007 and 2015, 1034 patients with CHB were recruited. The mean age of the study population (639 men and 395 women) was 46.8 years. During AVT, the mREACH-B score significantly decreased from the baseline to 3 years of AVT (mean 9.21 → 7.46, P < 0.05) and was maintained until 5 years of AVT (mean 7.23, P > 0.05). The proportion of high-risk patients (mREACH-B score ≥11) was significantly reduced from the baseline to 2 years of AVT (36.4% → 16.4%, P < 0.001) and was maintained until 5 years of AVT (12.2%, P > 0.05). The mREACH-B scores at baseline and 1 year of AVT independently predicted HCC development (hazard ratio = 1.209-1.224) (all P < 0.05). The cumulative incidence rate of HCC was significantly different at 5 years of AVT among risk groups (high vs. high-intermediate vs. low-intermediate vs. low) from baseline (4.5% vs. 3.2% vs. 1.5% vs. 0.8%) and 1 year (11.8% vs. 4.6% vs. 1.8% vs. 0.6%) (all P < 0.05, log-rank tests).ConclusionsThe mREACH-B score was dynamically changed during AVT. Thus, repeated assessment of the mREACH-B score is required to predict the changing risk of HCC development in patients with CHB undergoing AVT.Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

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