{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:07:56Z","timestamp":1787166476823,"version":"build-2736575974"},"reference-count":35,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,9,22]],"date-time":"2020-09-22T00:00:00Z","timestamp":1600732800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Viral Hepatitis"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    This study was designed to explore if antiviral treatment influences the performance of serum alpha\u2010fetoprotein (AFP) for hepatocellular carcinoma (HCC) among the high\u2010risk chronic HBV\u2010infected patients. A total of 5936 patients who had evidence of chronic HBV infection were enrolled from four independent centres in this retrospective study, including 1721 chronic hepatitis B (CHB), 2286 liver cirrhosis (LC), 798 HCC within Milan criteria and 1131 HCC beyond Milan criteria patients. Stratified by whether they received treatment or not, the patients were further divided into antiviral and non\u2010antiviral groups. Then, the performance of AFP for discriminating HCC was evaluated. Patients receiving antivirals had significantly lower median levels of AFP compared with the non\u2010antiviral patients (\n                    <jats:italic>P<\/jats:italic>\n                    \u00a0&lt;\u00a0.001), and there were significantly less patients with abnormal AFP levels in antiviral groups (\n                    <jats:italic>P<\/jats:italic>\n                    \u00a0&lt;\u00a0.001). Antiviral therapy improved the AUROCs of AFP for discriminating HCC within Milan criteria. When setting the cut\u2010off values at 20\u00a0ng\/mL and 100\u00a0ng\/mL as surveillance and confirmatory tests respectively for HCC among patients receiving antiviral treatment, AFP exhibited a significantly higher sensitivity than those of 200\u00a0ng\/mL and 400\u00a0ng\/mL, which are currently recommended by some guidelines, without compromising specificity. Further analysis in antiviral patients revealed that serum AFP had better performance for discriminating HCC within Milan criteria in ALT\u00a0\u2264\u00a01ULN patients than that in ALT\u00a0&gt;\u00a01ULN patients. In conclusion, in the era of antiviral therapy, serum AFP's surveillance performance was substantially improved for HCC within Milan criteria among the high\u2010risk population of CHB and LC patients.\n                  <\/jats:p>","DOI":"10.1111\/jvh.13388","type":"journal-article","created":{"date-parts":[[2020,8,27]],"date-time":"2020-08-27T12:48:00Z","timestamp":1598532480000},"page":"20-29","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Reappraisal of the diagnostic value of alpha\u2010fetoprotein for surveillance of HBV\u2010related hepatocellular carcinoma in the era of antiviral therapy"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6485-0731","authenticated-orcid":false,"given":"Xiangjun","family":"Qian","sequence":"first","affiliation":[{"name":"Department of Microbiology &amp; Infectious Disease Center School of Basic Medical Sciences Peking University Health 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