SIG Greatest Hits: TLM 2025-Hepatitis B SIG: Hepatocellular Carcinoma Calculators in Clinical Practice REACH-B, mPAGE, GALAD, and ALBI Scores, and Special Populations

Hepatitis B SIG: Hepatocellular Carcinoma Calculators in Clinical Practice REACH-B, mPAGE, GALAD, and ALBI Scores, and Special Populations

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Video Transcription

Video Summary

The presentation discusses Hepatocellular carcinoma (HCC) risk scores—primarily PAGE-B, modified PAGE-B (mPAGE-B), and GALAD—emphasizing their clinical utility for prevention, surveillance, and prognosis. Early risk scores like RICH-B mainly target untreated Asian cohorts, identifying intermediate/high-risk patients for antiviral therapy initiation. However, their performance lessens in treated populations. PAGE-B and mPAGE-B, validated in treated populations, effectively exclude low-risk patients (high negative predictive value) and identify intermediate/high-risk groups for HCC surveillance, though risk might be underestimated in high-risk patients. Special populations (e.g., patients post-sustained virologic response, HDV/HIV co-infection, diabetics) require further study and recalibration. The GALAD and GAS scores incorporate biomarkers AFP, AFP-L3, and DCP, improving early HCC detection beyond AFP alone. AFPL3’s role may be minor, as GALAD without it remains effective. Dynamic biomarker trends further enhance prediction. Lastly, the ALBI score, based on albumin and bilirubin, is a simple, objective prognostic tool for survival in HCC and chronic liver disease. Overall, risk calculators are vital in guiding HCC management across diverse patient groups.

Asset Subtitle

Talk delivered by Dr. Terry Cheuk-Fung Yip. Talk was part of the Hot Topics in Hepatitis B: New Clinical Tools for Hepatitis B Management session.

Keywords

Hepatocellular carcinoma

PAGE-B risk score

GALAD score

HCC surveillance

ALBI prognostic score