Risk calculators for hepatocellular carcinoma in patients affected with chronic hepatitis B in Asia

Table 1 Scenario for chronic hepatitis B patients with various risk profiles

	Patient A	Patient B	Patient C	Patient D
Gender	Male	Female	Male	Female
Age (yr)	70	30	55	40
ALT (U/L)	100	15	25	40
HBeAg	Positive	Negative	Negative	Negative
HBV DNA (copies/mL)	> 106	< 300	104	105
Risk of HCC	Very high(but the exact risk is unknown)	Very low(but the exact risk is unknown)	Unknown	Unknown

ALT: Alanine transaminase; HBeAg: Hepatitis B e antigen; HBV: Hepatitis B virus; HCC: Hepatocellular carcinoma.

Table 2 The hepatocellular carcinoma risk calculators for patients with chronic hepatitis B which have been developed before 2011

	IPM[12]	GAG-HCC risk score[11]	CUHK clinical scoring system[10]	REVEAL nomograms[9]
Area	Korea	Hong Kong	Hong Kong	Taiwan
Origin of subjects	Hospital-based	Hospital-based	Hospital-based	Community-based
No. of subjects for derivation	2020	820	1005	2435
Feature of subjects	Not limited to CHB	CHB	CHB	CHB
No. of model	1	1	1	3
Risk predictors	Gender	Gender	Age	Gender
	Age	Age	Albumin	Age
	HCV infection	HBV DNA level	Bilirubin	ALT level
	HBV infection	CP mutations	HBV DNA level	Family history of HCC
	AFP level	Cirrhosis	Cirrhosis	Alcohol consumption
	Chronic hepatitis			HBeAg
	Cirrhosis			HBV DNA level
	Heavy alcoholics			HBV genotype
	ALT level
Risk function	Logistic regression	Cox regression	Cox regression	Cox regression
Predicted outcomes	HCC risk	5-yr and 10-yr HCC risk	5-yr and 10-yr HCC risk	5-yr and 10-yr HCC risk
Validation (No. of subjects for validation)	2-yr prospective validation (n = 833)	Leave-one-out cross-validation	External validation (n = 424)	External validation with data splitting (n = 1218)

ALT: Alanine transaminase; HBeAg: Hepatitis B e antigen; HBV: Hepatitis B virus; HCC: Hepatocellular carcinoma; CHB: Chronic hepatitis B.

Table 3 The most updated hepatocellular carcinoma risk score for chronic hepatitis B patients upgraded from the REVEAL nomogram

Baseline hepatocellular carcinoma predictor	Risk score
Age (yr)
30-34	0
35-39	1
40-44	2
45-49	3
50-54	4
55-59	5
60-65	6
Sex
Female	0
Male	2
Levels of ALT (IU/L)
< 15	0
15-44	1
≥ 45	2
Family history of hepatocellular carcinoma
No	0
Yes	2
HBeAg/HBV DNA/HBsAg/genotype
Negative/< 104/< 100/any type	0
Negative/< 104/100-999/any type	2
Negative/< 104/≥ 1000/any type	2
Negative/104-106/< 100/any type	3
Negative/104-106/100-999/any type	3
Negative/104-106/≥ 1000/any type	4
Negative/≥ 106/any level/B or B + C	5
Negative/≥ 106/any level/C	7
Positive/any level/any level/B or B + C	6
Positive/any level/any level/C	7

ALT: Alanine transaminase; HBeAg: Hepatitis B e antigen; HBsAg: Hepatitis B surface antigen.