Albumin-bilirubin score predicts HCC occurrence after DAA treatment
The albumin-bilirubin (ALBI) score, along with platelet count and aspartate aminotransferase-lymphocyte ratio (ALRI) index, is an effective and simple tool for identifying patients at risk of developing hepatocellular carcinoma (HCC) after treatment with direct-acting antivirals (DAA), a new study has found.
Researchers performed a retrospective cohort study including 514 cirrhosis patients scheduled for treatment with DAAs. Aside from ALBI score and ALRI index, baseline variables collected included neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII) and platelet-to-lymphocyte ratio (PLR).
Of the study participants, 416 did not have a previous diagnosis of HCC (median age at the start of therapy, 63.3 years; 58.2 percent male) while 98 did (median age at the start of therapy, 71.0 years; 61.2 percent male). The median follow-up time was 18.04 months.
Multivariable Cox regression analysis showed that ALBI score (hazard ratio [HR], 2.35, 95 percent CI, 1.05–5.25; p=0.038) and platelet count (HR, 0.92, 0.85–1.00; p=0.048) were both significantly and independently associated with the risk of HCC occurrence.
The cumulative hazards of HCC occurrence at 6, 12 and 18 months were 0.010, 0.050 and 0.072, respectively.
In comparison, ALRI index was the only pertinent factor for HCC recurrence in participants with a history of HCC (HR, 1.05; 1.01–1.09; p=0.007). In this group of patients, the cumulative hazards of recurrence at 6, 12 and 18 months were 0.074, 0.261 and 0.380, respectively.