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Background: Patients with chronic hepatitis B (CHB) infection are at an increased risk of developing hepatocellular carcinoma (HCC). Risk scores have been developed in Asian populations to predict HCC risk over time.
Aim: To assess the performance of HCC risk prediction models in a heterogeneous population of patients with CHB.
Methods: Scores were calculated at baseline using CU-HCC, REACH-B, NGM1-HCC, NGM2-HCC and GAG-HCC models and the incidence of HCC was determined. The predictive ability of each score was evaluated using the area under the receiver operating characteristic curve (AUROC), Cox regression and plots of observed versus predicted HCC. The predictive value of the scores was compared between Asian and non-Asian patients and between cirrhotic versus non-cirrhotic with and without treatment.
Results: Of 2105 patients, 70 developed HCC. Increasing risk score was associated with HCC in all models. The CU-HCC model had the highest AUROC in Asian (0.85) and non-Asian (0.91) patients. Patients identified as low risk by any model had a very low incidence of HCC (0-0.15 per year), with the highest proportion of patients identified as low risk using CU-HCC (67%) or GAG-HCC (78%). The risk of HCC was similar to predicted for low-risk and medium-risk patients but was lower than predicted for high-risk patients. Treated patients had a lower than predicted risk of HCC, particularly in non-cirrhotic high-risk patients with longer follow-up.
Conclusions: Although all models predicted the risk of HCC, models that incorporated parameters of liver function or cirrhosis (CU-HCC/GAG-HCC) were most accurate. Low-risk patients likely require reduced HCC surveillance.
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http://dx.doi.org/10.1136/gutjnl-2014-309099 | DOI Listing |
Am J Trop Med Hyg
December 2024
Department of Infectious Diseases, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China.
Typhoid fever is a human-specific disease caused by subspecies of Salmonella enterica (Salmonella Typhi). It spreads through ingestion of contaminated food or water and is diagnosed through blood culture or bone marrow culture. It typically presents as an intestinal infection, with a few patients developing severe disseminated infections.
View Article and Find Full Text PDFAm J Trop Med Hyg
December 2024
Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Dengue infection poses a significant public health challenge in tropical countries. In Thailand, children ages 5-14 years are among the groups with the highest incidence of dengue. This study aimed to determine the prevalence of gastrointestinal (GI) manifestations in children with dengue infection and assess prognostic factors for severe dengue.
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December 2024
Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Measles or rubeola is caused by an enveloped single-stranded RNA virus belonging to the genus Morbillivirus in the Paramyxoviridae family. Here, we present five adult measles patients. The laboratory confirmation of measles by serology/polymerase chain reaction (PCR) was carried out in the National Measles Laboratory as per WHO standard operating procedure at the Department of Virology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
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December 2024
Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China.
Although China has achieved malaria elimination certification, the risk of malaria transmission reintroduction due to imported malaria remains. We analyzed data on imported malaria cases collected from January 1, 2014 to December 31, 2021, using multivariable logistic regression analysis to identify the factors associated with severe and relapsing malaria. The odds of severe malaria were around 4-fold greater for patients who were initially diagnosed with a nonmalarial illness than for patients initially diagnosed with malaria.
View Article and Find Full Text PDFAm J Trop Med Hyg
December 2024
University Clinical Research Center, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali.
Unexplained fever poses significant diagnostic challenges in resource-limited settings like Bamako, Mali, where overlapping endemic diseases include malaria, HIV/AIDS, yellow fever, typhoid, and others. This study aimed to elucidate the infectious etiologies of acute febrile illnesses in this context. Acute febrile patients of any age were enrolled after informed consent or assent.
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