ArticleFrontiers in oncology2020
ALT Flare Predicts Hepatocellular Carcinoma Among Antiviral Treated Patients With Chronic Hepatitis B: A Cross-Country Cohort Study.
Article in Frontiers in oncology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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13 citing papers in PubMed, 20 citations in OpenAlex.
- An XGBoost-Based Multicenter Model for Predicting HBV-Related Hepatocellular Carcinoma: Development and Validation.Cancer medicine · 2026Article
- Novel blood signature for hepatocellular carcinoma screening.ESMO gastrointestinal oncology · 2025Article
- Article
- Mutational landscape of the surface antigen of hepatitis B virus in patients with hepatocellular carcinoma.Gut pathogens · 2025Article
- Immunotherapy for primary squamous cell carcinoma of the liver: A case report.Oncology letters · 2025Article
- A non-invasive predictive model based on multimodality ultrasonography images to differentiate malignant from benign focal liver lesions.Scientific reports · 2024Article
- In-silico studies on evaluating the liver-protective effectiveness of a polyherbal formulation in preventing hepatocellular carcinoma progression.In silico pharmacology · 2024Article
- Vitamin D receptor rs3782905 and vitamin D binding protein rs7041 polymorphisms are associated with hepatocellular carcinoma susceptibility in cirrhotic HCV patients.BMC medical genomics · 2023Article
- A noninvasive model discriminating significant histological changes in treatment-naive chronic hepatitis B patients with normal ALT.Virology journal · 2023Article
- Liver cancer risk-predictive molecular biomarkers specific to clinico-epidemiological contexts.Advances in cancer research · 2022Article
- Platelet-to-Portal Vein Width Ratio and Platelet-to-Spleen Thickness Ratio Can Be Used to Predict Progressive Liver Fibrosis Among Patients With HBV Infection With HBeAg-Negativity and a Normal ALT Level.Frontiers in medicine · 2022Article
- Animal Models of Hepatitis B Virus Infection-Success, Challenges, and Future Directions.Viruses · 2021Review
- Association of alanine aminotransferase flares with hepatitis B surface antigen loss and clinical outcomes in treated and untreated patients with chronic hepatitis B virus infection: A US retrospective cohort study.Therapeutic advances in infectious diseaseArticle
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Authors and funding
11 authors at 3 institutions in 2 countries.
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Abstract
objectivesAlanine aminotransferase (ALT) level is one of the crucial indexes to evaluate disease status for chronic hepatitis B (CHB) patients. However, whether the ALT level after nucleos(t)ide analog (NA) treatment is associated with hepatocellular carcinoma (HCC) development remains unclear. MATERIALS AND
methodsWe evaluated the association between ALT level and HCC occurrence in NA-treated patients and investigated the predictive value of ALT flare for HCC. The associations between ALT level and HCC were analyzed by logistic regression and Cox proportional hazards models.
resultsThere were 21,223 CHB patients at Ruijin Hospital of China and 16,737 CHB patients in the Optum electronic health records (EHR) in the United States (US) treated with NAs between 2010 and 2018. Among them, 8,152 and 4,893 patients who achieved a normal ALT value were included in the study cohorts, respectively. A significant positive dose-dependent correlation between the peak ALT level and HCC was identified in both cohorts. Within the China cohort, ALT flare was significantly associated with increased risks of HCC compared to normal ALT (HR 2.55, 95%CI 1.45-4.50). Stronger increased risks associated with ALT flare were observed in the US cohort (HR 7.62, 95%CI 4.85-11.98).
conclusionsALT flare is a strong predictor for HCC occurrence in the CHB patients treated with NAs. Elevation of ALT, especially ALT flare warrants close monitoring for early HCC detection.
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