Chronic hepatitis B, a liver cancer risk to be taken seriously
Chronic hepatitis B is an infectious disease caused by the hepatitis B virus (HBV). It affects some 250 million people worldwide and is a major risk factor for hepatocellular carcinoma (HCC), the most common form of liver cancer. However, assessing each patient’s individual risk remains a challenge in clinical practice. That’s why French researchers have developed an innovative predictive score that combines behavioral factors with simple biological parameters available during routine medical monitoring.
An innovative predictive score to identify at-risk patients
For their study, the researchers analyzed data from the French ANRS CO22 Hepather cohort, which follows over 20,000 people with chronic hepatitis B and/or C. Of the 4,370 HBV-infected patients, 56 developed liver cancer during the eight years of follow-up. Using a statistical model, the researchers identified six factors associated with an increased risk of HCC: patient age, superinfection with hepatitis Delta virus, risky alcohol consumption, low platelet count, smoking and anti-HBV treatment. These factors were then integrated into a predictive score, called Adaptt, which can be easily calculated from data available during routine medical follow-up.
A score for use in outpatient clinics and resource-constrained settings
The Adaptt score can be used to accurately identify patients at risk of HCC, with predictive performance comparable to that of existing tools. The researchers have also developed a version of the score, called Sadaptt, which takes into account daily consumption of soft drinks, known to promote hepatic steatosis. With these scores, healthcare professionals will be able to anticipate the onset of HCC and propose appropriate follow-up measures for patients with chronic hepatitis B. What’s more, they can be used in outpatient clinics or in resource-constrained settings, thanks to the use of simple, easily identifiable data.
Better anticipation by acting on lifestyle habits
The aim is simple: to ensure proper monitoring and care for all patients with chronic hepatitis B. This also requires concrete solutions: reduce or interrupt nicotine and alcohol consumption, limit intake of sugary drinks, carefully monitor recommended treatments and comply with doctor’s follow-ups.
In various geographical regions, the next step will be to verify the scores in other cohorts. This will ensure that the scores are not affected by ethnic origins,” says Clémence Ramier. We also need to disseminate the device to the medical community.
The ADAPTT and SADAPTT scores could be used to determine liver fibrosis based on simple parameters (age, transaminase and platelet levels). Adapt and Sadapt scores would enable precise monitoring at every stage of liver disease progression, reducing the risk of liver cancer.
Clémence Ramier is a doctoral student in public health and Camelia Protopopescu is an Inserm research engineer in the Cancer and the fight against inequalities in prevention and care team(Calipso), part of the Sciences économiques et sociales de la santé et traitement de l’information médicale unit (Sesstim, Inserm/IRD/Aix-Marseille Université joint research unit 1252), in Marseille..
Sources :
C. Ramier et al. Behaviour-Based Predictive Scores of Hepatocellular Carcinoma in People With Chronic Hepatitis B (ANRS CO22 HEPATHER). Liver International, 2025 Apr;45(4):e70065 DOI:10.1111/liv.70065s
This article has been adapted from content published by Inserm. Find the source article and all references on the Inserm website.