Comparing validated hepatocellular carcinoma risk scores for chronic hepatitis B against current Australian surveillance guidelines

Table 1 Risk factors for hepatocellular carcinoma in patients with chronic hepatitis B

Risk factors for HCC in chronic hepatitis B
Asian men over the age of 40
Asian women over the age of 50
Sub-Saharan Africans over the age of 20
Aboriginal and Torres Strait Islander people over the age of 50
Co-infection with hepatitis delta virus
Family history of a 1st degree relative with HCC

HCC: Hepatocellular carcinoma.

Table 2 Risk Estimation for Hepatocellular Carcinoma in Chronic Hepatitis B scoring

Risk Estimation for Hepatocellular Carcinoma in Chronic Hepatitis B
Sex	Female	0
	Male	2
Age (years)	30-34	0
	35-39	1
	40-44	2
	45-49	3
	50-54	4
	55-59	5
	60-65	6
ALT (U/L)	< 15	0
	15-44	1
	≥ 45	2
HBeAg status	Negative	0
	Positive	2
HBV virus DNA level (copies/mL)	< 300-9999	0
	10000-99999	3
	100000-999999	5
	≥ 106	4

ALT: Alanine aminotransferase; HBeAg: Hepatitis B e antigen; HBV: Hepatitis B virus.

Table 3 Modified Risk Estimation for Hepatocellular Carcinoma in Chronic Hepatitis B scoring

Modified Risk Estimation for Hepatocellular Carcinoma in Chronic Hepatitis B scoring
Sex	Female	0
	Male	2
Age (years)	30-34	0
	35-39	1
	40-44	2
	45-49	3
	50-54	4
	55-59	5
	60-65	6
ALT (U/L)	< 15	0
	15-44	1
	≥ 45	2
HBeAg status	Negative	0
	Positive	2
LSM (kPa)	< 8.0	0
	8.0-13.0	2
	> 13.0	4

ALT: Alanine aminotransferase; HBeAg: Hepatitis B e antigen; LSM: Liver stiffness measurement.

Table 4 Platelet Age Gender-Hepatitis B scoring

Platelet Age Gender-Hepatitis B scoring
Age (years)	16-29	0
	30-39	2
	40-49	4
	50-59	6
	60-69	8
	≥ 70	10
Sex	Female	0
	Male	6
Platelet count (mm3)	≥ 200000	0
	100000-199999	6
	< 100000	9

Table 5 Baseline characteristics of the study population, n (%)/mean ± SD

Characteristics
Demographics	Total (n)	314
	Age	50.6 ± 13.1
	Male sex	110 (35.0)
Continent of origin	Asia	219 (69.7)
	Oceania	63 (20.0)
	Europe	17 (5.4)
	Africa	10 (3.2)
	Unknown	5 (1.6)
Clinical	LSM (kPa)	5.3 ± 1.8
	Current antiviral use	119 (37.9)
	Diabetes	16 (5.1)
	Excess alcohol use	38 (12.1)
	1st degree family history HCC	20 (6.7)
	2nd degree family history HCC	13 (4.1)
Biochemical	ALT (U/L)	45 ± 196.3
	Platelet count (× 109/L)	240.9 ± 64.3
	AFP (μg/L)	4.3 ± 21.3
	HBeAg positive	30 (9.6)
	HBV DNA < 2000 IU/mL	188 (59.9)
HCC development	Progression to HCC	2 (0.63)

HCC: Hepatocellular carcinoma; LSM: Liver stiffness measurement; HBeAg: Hepatitis B e antigen; ALT: Alanine aminotransferase; AFP: Alpha foetoprotein; HBV: Hepatitis B virus.

Table 6 Clinical characteristics of patients who developed hepatocellular carcinoma during follow-up

	Patient 1	Patient 2
Age (years)	40	50
Sex	Male	Female
Country of birth	Uganda	China
HBV treatment status	Untreated	Treated
HBV DNA (IU/mL)	1.3 × 103	0
HBeAg status	Negative	Negative
ALT (U/L)	63	14
Platelet count	360	221
AFP	28	315
LSM (kPa)	5.2	5.1
Diabetes	No	No
Excess alcohol use	No	No
Family history hepatocellular carcinoma	No	No

HBV: Hepatitis B virus; HBeAg: Hepatitis B e antigen; ALT: Alanine aminotransferase; AFP: Alpha foetoprotein; LSM: Liver stiffness measurement.

Table 7 Hepatocellular carcinoma risk score results of patients who developed hepatocellular carcinoma during follow-up

Patient	REACH-B score	mREACH-B score	PAGE-B score	Surveillance eligibility according to GESA
1	9	9	8	Yes
2	4	4	6	Yes

REACH-B: Risk Estimation for Hepatocellular Carcinoma in Chronic Hepatitis B; mREACH-B: Modified Risk Estimation for Hepatocellular Carcinoma in Chronic Hepatitis B; PAGE-B: Platelet Age Gender-Hepatitis B; GESA: Gastroenterological Society of Australia.