Surveillance for hepatocellular carcinoma in people of African ancestry with HIV and Hepatitis B

2021 ◽  
pp. 095646242110428
Author(s):  
Nisha Patel ◽  
Frank A Post
Keyword(s):  
Hepatocellular Carcinoma ◽  
High Risk ◽  
Hepatitis B ◽  
African Ancestry ◽  
Evidence Base ◽  
Electronic Patient Records ◽  
Asian Ethnicity ◽  
Hiv Rna ◽  
Asian Populations ◽  
Ultrasound Surveillance

Current guidelines recommend six-monthly ultrasound surveillance for hepatocellular carcinoma (HCC) in high risk, non-cirrhotic people with HIV and hepatitis B co-infection (HBV). African or Asian ethnicity is considered a risk factor for the development of HCC. Risk stratification scores for HCC have been generated in HBV mono-infected Caucasian and Asian populations, however they not been validated in people with HIV or those of African ancestry. We undertook an audit of HCC surveillance in HIV/HBV co-infected individuals of African ancestry who participated in the GEN-AFRICA study. Electronic patient records were reviewed for liver disease characteristics. REACH-B and PAGE-B scores were calculated to ascertain whether individuals at greatest risk of developing HCC were being targeted for ultrasound surveillance. 76 individuals (median age 51 years, 96% HIV RNA < 200 copies/mL, 87% HBV DNA <20 IU/mL) were included. 7% of participants had undergone six-monthly HCC surveillance by liver ultrasound (5% of those at low risk; 9% at intermediate or high risk). Adherence to HCC surveillance was poor and not targeted to those at highest risk. Lack of an evidence base for intensive HCC screening of non-cirrhotic, HIV/HBV co-infected individuals of African ancestry may have contributed to the poor uptake of biannual HCC ultrasound surveillance.

scholarly journals Post-operative AFP identifies a subset of patients at high risk of early recurrence in hepatitis b-associated hepatocellular carcinoma

HPB ◽  
2017 ◽  
Vol 19 ◽  
pp. S102-S103
Author(s):  
S. Bhagwandin ◽  
Q. Wang ◽  
W. Luan ◽  
L. Warren ◽  
M. Fiel ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
High Risk ◽  
Hepatitis B ◽  
Early Recurrence

Hepatocellular carcinoma (HCC) and hepatic hydatid disease (HHD)

2018 ◽  
pp. 421-430
Author(s):  
Abdullah Jibawi ◽  
Mohamed Baguneid ◽  
Arnab Bhowmick
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Radiofrequency Ablation ◽  
High Risk ◽  
Hepatitis B ◽  
Hydatid Disease ◽  
Risk Groups ◽  
Hepatic Hydatid Disease ◽  
Surgical Options ◽  
Hepatic Hydatid

Hepatocellular carcinoma (HCC) is strongly associated with cirrhosis. High-risk groups include those with hepatitis due to hepatitis B (HBV) or C (HCV) virus. This chapter provides an algorithm for investigating liver nodules in order to diagnose hepatocellular carcinoma. It explores surgical options including resection, liver transplantation, and minimally invasive options, such as radiofrequency ablation. Palliative options are described and an algorithm for the treatment of HCC is presented. The chapter also discusses hepatic hydatid disease, caused by the metacestode stages of Echinococcus granulosus and E. multilocularis.

Clinical Scoring System to Predict Hepatocellular Carcinoma in Chronic Hepatitis B Carriers

2010 ◽  
Vol 28 (10) ◽  
pp. 1660-1665 ◽  
Author(s):  
Vincent Wai-Sun Wong ◽  
Stephen Lam Chan ◽  
Frankie Mo ◽  
Tung-Ching Chan ◽  
Herbert Ho-Fung Loong ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
High Risk ◽  
Hepatitis B ◽  
Validation Cohort ◽  
Survival Rates ◽  
Clinical Score ◽  
Risk Groups ◽  
Prediction Score ◽  
Five Factors ◽  
Clinical Scoring

Purpose Hepatitis B virus (HBV) infection is an important etiology for hepatocellular carcinoma (HCC). We aim to develop a simple clinical score in predicting the risk of HCC among HBV carriers. Patients and Methods We first evaluated 1,005 patients and found that the following five factors independently predicted HCC development: age, albumin, bilirubin, HBV DNA, and cirrhosis. These variables were used to construct a prediction score ranging from 0 to 44.5. The score was validated in another prospective cohort of 424 patients. Results During a median follow-up of 10 years, 105 patients (10.%) in the training cohort and 45 patients (10.6%) in the validation cohort developed HCC. Cutoff values of 5 and 20 best discriminated HCC risk. By applying the cutoff value of 5, the score excluded future HCC development with high accuracy (negative predictive value = 97.8% and 97.3% in the training and validation cohorts, respectively). In the validation cohort, the 5-year HCC-free survival rates were 98.3%, 90.5%, and 78.9% in the low-, medium-, and high-risk groups, respectively. The hazard ratios for HCC in the medium- and high-risk groups were 12.8 and 14.6, respectively. Conclusion A simple prediction score constructed from routine clinical and laboratory parameters is accurate in predicting HCC development in HBV carriers. Future prospective validation is warranted.

Abstract 3969: Hepatic microRNA as biomarker for detection of hepatocellular carcinoma in high-risk chronic Hepatitis B patients

2015 ◽  
Author(s):  
Amit Ghosh ◽  
Alip Ghosh ◽  
Somenath Datta ◽  
Debanjali Dasgupta ◽  
Soumyajit Das ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Chronic Hepatitis ◽  
High Risk ◽  
Hepatitis B ◽  
Chronic Hepatitis B

scholarly journals Is hepatocellular carcinoma surveillance in high-risk populations effective?

2020 ◽  
Vol 7 (3) ◽  
pp. HEP25
Author(s):  
Kristeen Onyirioha ◽  
Sukul Mittal ◽  
Amit G Singal
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatitis B Virus ◽  
High Risk ◽  
Hepatitis B ◽  
Test Performance ◽  
Controlled Trial ◽  
Patient Characteristics ◽  
Chronic Hepatitis B Virus ◽  
B Virus ◽  
Risk Patients

Several professional societies recommend hepatocellular carcinoma (HCC) surveillance in high-risk patients including patients with cirrhosis from any etiology and subsets of noncirrhotic chronic hepatitis B virus infection. The efficacy of HCC surveillance to increase early detection and improve survival has been demonstrated in a large randomized controlled trial among hepatitis B virus patients and several cohort studies among those with cirrhosis. However, the effectiveness on HCC surveillance, when applied in clinical practice, is lower due to low utilization of HCC surveillance among at-risk patients, poorer test performance given operator dependency and differences in patient characteristics, and downstream process failures such as treatment delays. Interventions to increase surveillance utilization and improve surveillance test performance should improve surveillance effectiveness in the future.

scholarly journals Screening for Hepatocellular Carcinoma in Patients with Hepatitis B

Viruses ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1318
Author(s):  
Yashasavi Sachar ◽  
Mayur Brahmania ◽  
Renumathy Dhanasekaran ◽  
Stephen E. Congly
Keyword(s):  
Hepatocellular Carcinoma ◽  
Chronic Hepatitis ◽  
Risk Factor ◽  
High Risk ◽  
Hepatitis B ◽  
Risk Stratification ◽  
Significant Risk ◽  
Health Resources ◽  
Significant Risk Factor ◽  
Significant Morbidity

Chronic hepatitis B (CHB) infection is a significant risk factor for developing hepatocellular carcinoma (HCC). As HCC is associated with significant morbidity and mortality, screening patients with CHB at a high risk for HCC is recommended in an attempt to improve these outcomes. However, the screening recommendations on who to screen and how often are not uniform. Identifying patients at the highest risk of HCC would allow for the best use of health resources. In this review, we evaluate the literature on screening patients with CHB for HCC, strategies for optimizing adherence to screening, and potential risk stratification tools to identify patients with CHB at a high risk of developing HCC.

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