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Background and aims: Fibrosis-4 (FIB-4) index is a HCC predictor in chronic hepatitis B (CHB) patients. However, little is known about whether FIB-4 helps identify non-cirrhotic CHB patients with minimal HCC risk after prolonged nucleos(t)ide analogue (NA) therapy. Methods: A total of 1936 ethnically diverse, non-cirrhotic CHB patients were enrolled in this retrospective multi-national study. All patients received prolonged NA treatment, including entecavir and tenofovir disoproxil fumarate. We explored whether FIB-4 cutoff of 1.30, a marker indicative of mild fibrosis severity, could stratify HCC risks in these patients. Results: A total of 48 patients developed HCC after a mean follow-up of 6.98 years. FIB-4 level at 1 year after treatment (1-year FIB-4) was shown to be associated with HCC development and was superior to pre-treatment FIB-4 value. When patients were stratified by 1-year FIB-4 of 1.30, the high FIB-4 group was at an increased HCC risk compared to the low FIB-4 group, with a hazard ratio of 4.87 (95% confidence interval: 2.48–9.55). Multivariable analysis showed that sex and 1-year FIB-4 were independent predictors, with none of the 314 female patients with low 1-year FIB-4 developing HCC. Finally, 1-year FIB-4 of 1.30 consistently stratified HCC risks in patients with low PAGE-B score, a score composed of baseline age, sex and platelet count, and the annual incidence rate of HCC was 0.11% in those with PAGE-B < 10 + 1-year FIB-4 < 1.30. Conclusions: In non-cirrhotic CHB patients receiving prolonged NA therapy, 1-year FIB-4 < 1.30 is useful for identifying those with minimal HCC risk by combining with female sex or low PAGE-B score. © 2021, Asian Pacific Association for the Study of the Liver.

The Wuhe complex (WC), exposed at the southeastern margin of the North China Craton (NCC), is an important constituent of the Eastern Block of the NCC. In order to better understand the Precambrian crustal composition and evolution of this region, a comprehensive investigation on zircon geochronology and Hf isotopes, as well as whole-rock geochemistry and Sr-Nd-Pb isotopes was conducted on alkaline ultrapotassic granitic gneisses from the WC at Mashan. These gneisses are considered as meta-igneous rocks based on geochemical and mineralogical criteria (with special reference to zircon cathodoluminescence images). They are characterized by modally abundant alkali feldspar (more than 60%) and quartz (more than 30%) while plagioclase is rare. Mafic minerals are sodic amphiboles such as arfvedsonite and eckermannite, aegirine and rare biotite. Minor constituents are rutile, muscovite, apatite and barite. Major elements geochemistry shows high SiO2 (69.85%–74.51%) and K2O + Na2O (9.67%–12.17%) contents, high K2O/Na2O (7.41–22.53) ratios, and relatively low MgO (0.37%–0.87%) and CaO (0.10%–0.23%) contents. Trace elements geochemistry shows significant depletions of Nb, Y, Ce, Ga, and REE (rare earth elements) relative to anorogenic granites. These features suggest that the magmatic protoliths of the studied gneisses belong to ultrapotassic silica-saturated alkaline series from an extensional background, perhaps in a subduction-related rifting environment. As concerning isotope geochemistry, their 206Pb/204Pb, 207Pb/204Pb and 208Pb/204Pb ratios are 16.6297–17.1877, 15.4454–15.5066, and 36.6036–38.0304, respectively, and eNd(t) values vary from −1.7 to +9.1. Two samples yielded zircon 207Pb/206Pb ages of 2615 ± 4 Ma and 2617 ± 5 Ma, respectively, representing their precursor ages. The zircon igneous core domains exhibit oscillatory growth zoning with positive eHf (t) values (+2.5 − +6.6). These data, coupled with chondrite-normalized and primitive-mantle-normalized element patterns, suggest that the precursors of the studied granitic gneisses were mainly derived from a subduction-modified ultrapotassic syenitic parental magma, and may be considered as a particular group of A-type granites, involved in an important crustal growth and reworking event at ~2.6 Ga. These rocks experienced a granulite-facies metamorphic stage accompanied by partial melting, as testified by clinopyroxene + rutile + K-feldspar + spinel + quartz + apatite inclusions in zircon metamorphic domains which were dated at ~2.5 Ga. The occurrence of this metamorphic stage is also supported by the lower ΣREE contents, negative Eu anomalies, and high Ti-in-zircon temperatures (>800 °C) of metamorphic zircon mantles dated at ~2.5 Ga. Eventually, the studied rocks suffered a later ~1.85 Ga metamorphic overprinting, possibly related to the Paleoproterozoic collisional orogeny recorded in the region.