Data Sheet 1_Baseline low-level viremia in HBV-related hepatocellular carcinoma: prognostic significance, risk stratification, and clinical implications.docx

Model 1 used the full candidate variable set, whereas Model 2 used non-imaging variables. Predictors were selected using LASSO Cox regression and Boruta, and five survival algorithms were compared within the training set.</p>Results<p>Baseline LLV was associated with poorer OS. After PSM, HBV DNA <20 IU/mL was associated with lower adjusted mortality than LLV (hazard ratio, 0.688; 95% confidence interval, 0.543–0.872; P = 0.002), with similar findings after IPTW.

Patients with LLV had a lower peripheral CD4/CD8 ratio, and exploratory analyses identified significant indirect associations through albumin, aspartate aminotransferase, and systemic immune-inflammation response index. Model 1 retained tumor size, tumor multiplicity, portal vein tumor thrombus, cholinesterase, alkaline phosphatase, and alpha-fetoprotein; Model 2 retained gamma-glutamyl transferase, cholinesterase, alkaline phosphatase, and alpha-fetoprotein.

Random survival forest was selected based on overall training performance. In the reserved validation set, the 1-, 3-, and 5-year time-dependent AUCs were 0.824, 0.777, and 0.765 for Model 1 and 0.769, 0.742, and 0.723 for Model 2, respectively. Both models showed good calibration and positive net benefit.</p>Discussion<p>Baseline LLV remained prognostically relevant after HCC diagnosis and was accompanied by exploratory differences in systemic inflammation and the relative balance of peripheral T cell subsets.

These findings support closer virological monitoring and individualized risk assessment.</p>