{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T16:30:23Z","timestamp":1787157023756,"version":"build-2736575974"},"reference-count":34,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T00:00:00Z","timestamp":1784160000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T00:00:00Z","timestamp":1784160000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dig Dis"],"abstract":"<jats:p>Introduction: In patients receiving nucleos(t)ide analog (NA) therapy for chronic hepatitis B (CHB)-related cirrhosis, routine endoscopic surveillance may be deferred in the absence of high-risk varices (HRV). We aimed to identify predictors of incident HRV in this population. Methods: This retrospective cohort study included patients with CHB-related cirrhosis who initiated NA therapy between March 2008 and June 2020 and were followed through May 2024. Eligible patients underwent baseline and on-treatment upper endoscopy. Patients with baseline HRV, prior variceal ligation, use of nonselective \u03b2-blockers, other viral hepatitis, alcohol overuse, or malignancy were excluded. The cumulative incidence of HRV and adjusted subdistribution hazard ratios (aSHRs) were estimated using competing-risk methods. A point-based risk prediction model was derived from multivariable regression coefficients. Results: Among the 110 included patients, 14 (12.7%) developed HRV over a median follow-up of 3.6 years (IQR, 2.0\u20135.6). In multivariable analysis, fibrosis-4 (FIB-4) \u22654.0 (aSHR 9.77; 95% CI, 1.45\u201365.7), coexisting metabolic dysfunction-associated steatotic liver disease (MASLD) (aSHR 6.37; 95% CI, 1.84\u201322.0), and albumin-bilirubin (ALBI) grade &gt;1 (aSHR 3.02; 95% CI, 1.21\u20137.55) were independently associated with incident HRV and were assigned 3, 2, and 1 point, respectively, in the prediction model. At 3 years, the cumulative incidence of HRV was 1.5% (95% CI, 0\u20134.5) in the low-risk group (0\u20133 points) and 21.4% (95% CI, 8.0\u201334.8) in the high-risk group (4\u20136 points) (p = 0.001). Conclusion: MASLD, FIB-4, and ALBI grade predict incident HRV in NA-treated CHB cirrhosis, enabling risk-stratified endoscopic surveillance.<\/jats:p>","DOI":"10.1159\/000553519","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T16:01:05Z","timestamp":1784217665000},"page":"1-10","source":"Crossref","is-referenced-by-count":0,"title":["Predictors of Incident High-Risk Varices in Patients with Hepatitis B-Related Cirrhosis Receiving Nucleos(t)ide Analog Therapy"],"prefix":"10.1159","author":[{"given":"Yu-Chia","family":"Chiu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsin-Ju","family":"Tsai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia-Chang","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying-Cheng","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shou-Wu","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4097-4315","authenticated-orcid":false,"given":"Teng-Yu","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2026,7,16]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1097\/HEP.0000000000000647"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2015.05.022"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2021.12.022"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.3389\/ti.2023.11122"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1111\/jvh.13603"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.3390\/jpm12020239"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2023.11.017"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000000266"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1159\/000539167"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1097\/mcg.0b013e318157464b"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.73768"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.3350\/cmh.2024.0898"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2023.102065"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(21)01374-x"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.5997"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1056\/nejmcp2402121"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.57.9151"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21178"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1097\/HEP.0000000000000843"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1007\/s12072-024-10774-3"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1002\/sim.7501"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.115.017719"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-019-00967-w"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1111\/liv.13271"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2025.06.014"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-28351-3"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2024.12.009"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21669"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2019.01.011"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1111\/jvh.12638"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.21873\/invivo.12364"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31875-0"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2022.05.021"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2024.04.031"}],"container-title":["Digestive 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