{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T21:42:56Z","timestamp":1792618976101,"version":"4.5.0"},"reference-count":32,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T00:00:00Z","timestamp":1757376000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T00:00:00Z","timestamp":1757376000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100015383","name":"Stichting voor Lever- en Maag-Darm Onderzoek","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100015383","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005564","name":"Gilead Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005564","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Metabolic dysfunction and metabolic dysfunction\u2010associated steatotic liver disease (MASLD) are associated with an increased risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB). We aimed to study risk factors for HCC and to assess the performance of the PAGE\u2010B score in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We included CHB patients with \u2265\u20091 metabolic comorbidity from nine centres. Steatosis was diagnosed by ultrasound, CAP, or histology. Risk factors were analysed by Cox regression, and the performance of the PAGE\u2010B score was assessed in the overall population and across relevant subgroups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We included 1922 patients. 1730 (90.0%) were overweight, 434 (22.6%) had hypertension, 254 (13.2%) dyslipidemia, 230 (12.0%) diabetes and 732 (38.1%) MASLD. Presence of cirrhosis, older age, lower platelets and lower albumin were independent risk factors for HCC. The 5\u2010year HCC risk was 0.1%\/2.0%\/12.4% patients with low\/intermediate\/high PAGE\u2010B scores (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Consistent results were obtained in patients with MASLD (0\/2.8\/11.1% for low, intermediate and high PAGE\u2010B scores (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001)). PAGE\u2010B stratified risk in patients without cirrhosis (0% vs. 1.2% and 1.8%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Among the subset of patients with cirrhosis, risks were 4.2% (low), 6.9% (intermediate) and 27.3% (high) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CHB patients with metabolic dysfunction and\/or MASLD are at significant risk of HCC. The PAGE\u2010B score can be used to stratify HCC risk in this population, with negligible 5\u2010year HCC incidence in those without cirrhosis and low PAGE\u2010B scores. However, caution should be exercised in patients with cirrhosis in whom HCC risk remains significant even among those with a low PAGE\u2010B score.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apt.70360","type":"journal-article","created":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T07:46:37Z","timestamp":1757403997000},"page":"374-382","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Prediction of Hepatocellular Carcinoma and Other Liver\u2010Related Events in Chronic Hepatitis B Patients With Metabolic Dysfunction or Metabolic Dysfunction\u2010Associated Steatotic Liver Disease"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2911-2140","authenticated-orcid":false,"given":"Lesley A.","family":"Patmore","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Erasmus MC  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivana","family":"Carey","sequence":"additional","affiliation":[{"name":"Institute of Liver Studies King's College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan J.","family":"Feld","sequence":"additional","affiliation":[{"name":"Toronto Centre for Liver Disease Toronto General Hospital, University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8713-1481","authenticated-orcid":false,"given":"Willem P.","family":"Brouwer","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Erasmus MC  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4677-3127","authenticated-orcid":false,"given":"Keyur","family":"Patel","sequence":"additional","affiliation":[{"name":"Toronto Centre for Liver Disease Toronto General Hospital, University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0732-3078","authenticated-orcid":false,"given":"Maria","family":"Buti","sequence":"additional","affiliation":[{"name":"Liver Unit, Hospital University Valle d'Hebron and CIBEREHD del INstinuto Carlos III  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pieter","family":"Honkoop","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Albert Schweitzer Hospital  Dordrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douwe F.","family":"Postma","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Infectious Diseases University Medical Center Groningen  Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Blokzijl","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology University Medical Center Groningen  Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d6zgur. M.","family":"Koc","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Maastricht University Medical Center  Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"van Oorschot","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Maastricht University Medical Center  Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kosh","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Institute of Liver Studies King's College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"van der Valk","sequence":"additional","affiliation":[{"name":"Stichting HIV Monitoring  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faydra I.","family":"Lieveld","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology University Medical Center Utrecht  Utrecht the Netherlands"},{"name":"Department of Internal Medicine and Infectious Diseases University Medical Center Utrecht  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mai","family":"Kilany","sequence":"additional","affiliation":[{"name":"Toronto Centre for Liver Disease Toronto General Hospital, University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthijs","family":"Kramer","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Maastricht University Medical Center  Maastricht the Netherlands"},{"name":"GROW\u2014School for Oncology and Reproduction Maastricht University  Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joep","family":"de Bruijne","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology University Medical Center Utrecht  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark A. A.","family":"Claassen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Infectious Diseases Rijnstate Hospital  Arnhem the Netherlands"},{"name":"Department of Infectious Diseases, Amsterdam Institute for Immunology &amp; Infectious Diseases, Amsterdam UMC University of Amsterdam  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bettina E.","family":"Hansen","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics Erasmus MC  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A.","family":"de Man","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Erasmus MC  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harry L. A.","family":"Janssen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Erasmus MC  Rotterdam the Netherlands"},{"name":"Toronto Centre for Liver Disease Toronto General Hospital, University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. Bart","family":"Takkenberg","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Amsterdam University Medical Center  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9253-563X","authenticated-orcid":false,"given":"Milan J.","family":"Sonneveld","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Erasmus MC  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,9]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"WHO \u201cHepatitis B\u2014Fact Sheet: World Health Organiszation \u201d2024 https:\/\/www.who.int\/news\u2010room\/fact\u2010sheets\/detail\/hepatitis\u2010b."},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.30857"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhepr.2021.100350"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2023.03.024"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2017.07.001"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2015.11.035"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2019.12.005"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2023.10.019"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2023.02.004"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2018.03.019"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2018.02.032"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.70042"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)15268-3"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.13488"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2018.07.018"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2020.07.025"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2017.09.044"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.29800"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2022.12.029"},{"key":"e_1_2_10_21_1","article-title":"Prediction of Hepatocellular Carcinoma and Liver\u2010Related Events in Anti\u2010HDV Positive Individuals","author":"Patmore L. 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