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Hepatol Res. 2018 Oct 25. doi: 10.1111/hepr.13280. [Epub ahead of print]
A proposed model for the prediction of intrahepatic covalently closed circular DNA level in patients with chronic hepatitis B.
Hasegawa K1, Nishikawa H1, Enomoto H1, Iwata Y1, Sakai Y1, Ikeda N1, Takashima T1, Aizawa N1, Takata R1, Yoh K1, Ishii N1, Yuri Y1, Nishimura T1, Iijima H1, Hatano E2, Fujimoto J2, Nishiguchi S1.
Author information
1
Division of Hepatobiliary and Pancreatic disease, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
2
Division of Hepatobiliary and Pancreatic disease, Department of Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
Abstract
BACKGROUND:
We sought to create a prediction model for intrahepatic covalently closed circular DNA (IH-cccDNA) level in chronic hepatitis B (CHB) patients and to validate the model's predictive accuracy.
METHODS:
Patients who did not receive previous nucleoside analogue (NA) therapy were assigned to the training cohort (n=57), and those who received previous NA therapy were assigned to the validation cohort (n=69). Factors linked to IH-cccDNA levels in the training cohort were analyzed and a formula to predict IH-cccDNA level was constructed. Next, the reproducibility of that formula was assessed.
RESULTS:
In the multivariate analysis for the prediction of IH-cccDNA level in the training cohort, fasting blood sugar (FBS) (P=0.0227), hepatitis B e antigen (HBeAg) (P=0.0067) and Log10(HB surface antigen (HBsAg)) (P=0.0497) were significant, while HB core-related antigen (HBcrAg) tended to be significant (P=0.0562). The formula named the FBS-cres score based on the variables used (FBS, HBcrAg, HBeAg and HBsAg) was constructed. FBS-cres score was calculated as: 3.1686 - (0.0148×FBS) + (0.1982×HBcrAg) + (0.0008168×HBeAg) + (0.1761×log10(HBsAg)). In the training cohort, between HBcrAg level and IH-cccDNA level, significant correlation was noted (P<0.0001, r=0.67), while the FBS-cres score was more closely correlated to IH-cccDNA level (P<0.0001, r=0.81). In the validation cohort, between HBcrAg level and IH-cccDNA level, significant correlation was found (P=0.0012, r=0.38), while the FBS-cres score was more closely linked to IH-cccDNA levels (P<0.0001, r=0.51). Similar tendencies were observed in all subgroup analyses.
CONCLUSION:
Our proposed model for the prediction of IH-cccDNA level may be helpful in CHB patients.
This article is protected by copyright. All rights reserved.
KEYWORDS:
Chronic hepatitis B; Hepatitis B core-related antigen; Hepatitis B surface antigen; Intrahepatic covalently closed circular DNA; Predictive model
PMID:
30358027
DOI:
10.1111/hepr.13280 |
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