Identification of Chronic Hepatitis B Patients without Significant Liver Fibrosis by a Simple Noninvasive Predictive Model

Hui, Alex Yui; Chan, Henry Lik-Yuen; Wong, Vincent Wai-Sun; Liew, Choong-Tsek; Chim, Angel Mei-Ling; Chan, Francis Ka-Leung; Sung, Joseph Jao-Yiu
March 2005
American Journal of Gastroenterology;Mar2005, Vol. 100 Issue 3, p616
Academic Journal
OBJECTIVE: Histological assessment of liver fibrosis is important in the management of chronic hepatitis B (CHB) infection but poorly accepted by patients because of its invasiveness. The aim of this study was to develop a noninvasive model to assess liver fibrosis in CHB patients using clinical and routine laboratory data.PATIENTS AND METHODS: This was a retrospective study on 235 treatment-naïve viremic CHB patients. Univariate analysis of data from the training cohort (n= 150) followed by multivariate logistic regression were performed to identify independent predictors of significant fibrosis and generate predictive models. The models were validated with the remaining patients or validation cohort (n= 85) and by receiver operating characteristics (ROC) analysis.RESULTS: Body mass index (BMI), platelet count, serum albumin, and total bilirubin levels were identified as independent predictors of bridging fibrosis or cirrhosis (Ishak stage 3–6). ROC analysis was performed using the predictive probabilities derived from the regression models. The area under the ROC curve of the best model was 0.803 (95% CI: 0.729–0.878) for the training cohort, 0.765 (95% CI: 0.644–0.885) for the validation cohort, and 0.791 (95% CI: 0.728–0.854) for the entire cohort. Using the low cut-off probability of 0.15, significant fibrosis could be excluded in 83 patients of the total patient population (negative predictive value 0.92).CONCLUSIONS: Our noninvasive model comprising BMI and three routine laboratory tests was accurate in predicting absence of significant fibrosis. Application of this model could provide useful additional information on the stage of disease, guide future management decisions, and potentially decrease the need for liver biopsy in some CHB patients.(Am J Gastroenterol 2005;100:616–623)


Related Articles

  • The study of efficacy of lamivudine in patients with severe acute hepatitis B. Jian-Wu Yu; Li-Jie Sun; Yong-Hua Zhao; Peng Kang; Shu-Chen Li; Yu, Jian-Wu; Sun, Li-Jie; Zhao, Yong-Hua; Kang, Peng; Li, Shu-Chen // Digestive Diseases & Sciences;Mar2010, Vol. 55 Issue 3, p775 

    Background and Aim: Severe acute hepatitis B is a rapid deterioration of liver function, which carries a high mortality rate. The aim of this study is to evaluate the efficacy of lamivudine in patients with severe acute hepatitis B.Methods: In this study, 80 patients...

  • Noninvasive Markers of Liver Fibrosis and Inflammation in Chronic Hepatitis B-Virus Related Liver Disease. Mohamadnejad, Mehdi; Montazeri, Ghodrat; Fazlollahi, Atoosa; Zamani, Farhad; Nasiri, Jafar; Nobakht, Hossein; Forouzanfar, Mohammad Hossein; Abedian, Shifteh; Tavangar, Seyed Mohamad; Mohamadkhani, Ashraf; Ghoujeghi, Farhad; Estakhri, Arezoo; Nouri, Negin; Farzadi, Zahra; Najjari, Abolfazl; Malekzadeh, Reza // American Journal of Gastroenterology;Nov2006, Vol. 101 Issue 11, p2537 

    BACKGROUND/AIMS: Noninvasive markers for predicting significant fibrosis and inflammation have not yet been validated in an unselected group of chronic hepatitis B virus (HBV) carriers. The aim of this study was to create noninvasive models to predict significant fibrosis and inflammation in...

  • Comparison of the 48-week efficacy between entecavir and adefovir in HBeAg-positive nucleos(t) ide-naïve Asian patients with chronic hepatitis B: a meta-analysis. Pan Zhao; Weiwei Liu; Jun Zhao; Qun Guan // Virology Journal;2011, Vol. 8 Issue 1, p75 

    Background: Although entacavir and adefovir were widely used in most Asian countries, there were few conclusions drawn from a meta-analysis for comparing the efficacy between entecavir and adefovir in nucleos(t)ide-naïve Asian patients with chronic hepatitis B (CHB). The aim of this study was...

  • Mortality Secondary to Fulminant Hepatic Failure in Patients with Prior Resolution of Hepatitis B Virus Infection in Japan. Umemura, Takeji; Tanaka, Eiji; Kiyosawa, Kendo; Kumada, Hiromitsu // Clinical Infectious Diseases;9/1/2008, Vol. 47 Issue 5, pe52 

    Hepatitis B virus (HBV) reactivation in patients with resolved HBV infection was found in 23 (4%) of 552 newly hepatitis B surface antigen-positive patients in Japan. Because onefourth of cases develop into fulminant hepatic failure and mortality is 100%, management of HBV reactivation in...

  • PROFILE OF HEPATITIS B PATIENTS IN A REFERENCE SERVICE: RETROSPECTIVE STUDY.  // Revista Brasileira em Promoção da Saúde;jan-mar2014, Vol. 27 Issue 1, p53 

    Objective: To know the profile of patients with hepatitis B treated at the Liver Research Center (NEF) of the Federal University of Rio Grande do Norte (UFRN). Methods: Descriptive, retrospective study that analyzed 433 medical records with serological confirmation for 279 of them. Authors...

  • Cellular immune responses in patients with hepatitis B surface antigen seroclearance induced by antiviral therapy. Minfeng Liang; Shiwu Ma; Xiaoxiong Hu; Bin Zhou; Junchang Zhang; Jinjun Chen; Zhanhui Wang; Jian Sun; Xiaolin Zhu; William Abbott; Jinlin Hou // Virology Journal;2011, Vol. 8 Issue 1, p69 

    Background: The mechanisms by which chronic hepatitis B is completely resolved through antiviral therapy are unknown, and the contribution of acquired T cell immunity to hepatitis B surface antigen (HBsAg) seroclearance has not been investigated. Therefore, we measured the T-cell responses to...

  • Practice corner: should we screen all patients starting chemotherapy for chronic hepatitis B virus infection? McLachlan, Sue-Anne; De Cruz, Peter // Evidence Based Medicine;Feb2009, Vol. 14 Issue 1, p28 

    The article presents a study that aimed to find out the effect of screening the patients starting chemotherapy for chronic hepatitis B virus infection. It states that a 64 year-old Indian was admitted to the hospital with jaundice for eight months after finishing R-CHOP chemotherapy for diffuse...

  • Are Risk Factors Associated with Outcomes in Pancreatic Cancer? De-shen Wang; Zhi-qiang Wang; Le Zhang; Miao-zhen Qiu; Hui-yan Luo; Chao Ren; Dong-sheng Zhang; Feng-hua Wang; Yu-hong Li; Rui-hua Xu // PLoS ONE;Jul2012, Vol. 7 Issue 7, p1 

    Background: The development of pancreatic cancer is a process in which genes interact with environmental factors. We performed this study to determine the effects of the ABO blood group, obesity, diabetes mellitus, metabolic syndrome (MetS), smoking, alcohol consumption and hepatitis B viral...

  • Is SEN Virus a Major Concern in Hemodialysis and Liver Transplantation? Hosseini-Moghaddam, Seyed Mohammadmehdi; Mousavi, Seyedeh Hamideh; Alavian, Seyed-Moayed // Hepatitis Monthly;Winter2009, Vol. 9 Issue 1, p50 

    Although hepatotropic viruses such as hepatitis B virus (HBV) and hepatitis C virus (HCV) are well-identified viral agents for the development of hepatitis, infection with some other viruses may lead to varying degrees of liver injury. Moreover, the hepatic pathogenicity of a few viral agents...

  • An MLP Classifier for Prediction of HBV-Induced Liver Cirrhosis Using Routinely Available Clinical Parameters. Yuan Cao; Zhi-De Hu; Xiao-Fei Liu; An-Mei Deng; Cheng-Jin Hu // Disease Markers;2013, Vol. 35 Issue 6, p653 

    Background. Liver cirrhosis (LC) is the final stage of most of chronic liver diseases and is almost caused by chronic hepatitis B (CHB) in China. Liver biopsy is the reference method for the evaluation of liver cirrhosis. However, it is an invasive procedure with inherent risk. The aim of this...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics