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Development and Validation of a Risk Score for Liver Cirrhosis Prediction in Untreated and Treated Chronic Hepatitis B
An K Le, Hwai-I Yang, Ming-Lun Yeh, Mingjuan Jin, Huy N Trinh, Linda Henry, Anne Liu, Jian Q Zhang, Jiayi Li, Christopher Wong, Clifford Wong, Ramsey Cheung, Ming-Lung Yu, Mindie H Nguyen
The Journal of Infectious Diseases, Volume 223, Issue 1, 1 January 2021, Pages 139–146, https://doi.org/10.1093/infdis/jiaa330
Published:
11 June 2020
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Abstract
Background
Chronic hepatitis B (CHB) can progress to cirrhosis, but there are limited noninvasive tools available to estimate cirrhosis risk, including in patients receiving antiviral therapy. This study developed and validated a simple model to assess risk in CHB patients.
Methods
The derivation cohort included 3000 CHB patients from 6 centers in the United States, with 52.60% receiving antiviral therapy. External validation was performed for 4552 CHB individuals from similar cohorts in Taiwan, with 21.27% receiving therapy. Cox proportional hazards regression analyses were used to screen predictors and develop the risk score for cirrhosis. Areas under receiver operating characteristic curves (AUROCs) were calculated for predictive value.
Results
Sex, age, diabetes, antiviral treatment status/duration, hepatitis B e-antigen, and baseline alanine aminotransferase/aspartate aminotransferase levels were significantly associated with increased cirrhosis risk. A 13-point risk score was developed based on these predictors. The AUROCs for predicting cirrhosis risk were 0.82 at 3 years, 0.85 at 5 years, and 0.89 at 10 years in the derivation cohort, and 0.82, 0.79, and 0.77 in the validation cohort, respectively.
Conclusions
We developed and validated a simple cirrhosis prediction model with an independent external cohort that can be applied to both treatment-naive and treatment-experienced CHB patients in diverse settings and locations.
risk prediction, scoring system, area under the curve, variable selection, clinical tools, risk model
Topic:
diabetes mellitus diabetes mellitus, type 2 liver cirrhosis antiviral agents hepatitis b, chronic
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