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CN 22-1108/R
Volume 40 Issue 7
Jul.  2024
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Article Navigation >  Journal of Clinical Hepatology  > 2024  >  40(7): 1328-1333

Establishment of a noninvasive predictive model for antiviral therapy in patients with chronic hepatitis B virus infection and an age of ≤30 years

DOI: 10.12449/JCH240708
  • 1.

    Department of Liver Diseases，National Clinical Research Center for Infectious Disease，Shenzhen Third People’s Hospital，The Second Affiliated Hospital of Southern University of Science and Technology，Shenzhen，Guangdong 518116，China

  • 2.

    Department of Infectious Diseases，The First Hospital of Changsha，Changsha 410000，China

Research funding:

Shenzhen Key Medical Discipline Construction Fund (SZXK076)

More Information
  • Corresponding author: WANG Fang， kaixin919@163.com （ORCID： 0009-0003-0092-3403）
  • Received Date: 2023-11-08
  • Accepted Date: 2024-01-17
  • Published Date: 2024-07-25
    Abstract
  •   Objective  To predict whether antiviral therapy is required in patients with chronic hepatitis B virus （HBV） infection and an age of ≤30 years by establishing a noninvasive model， and to investigate the diagnostic value of this model.  Methods  A retrospective analysis was performed for the clinical data of 175 patients with chronic HBV infection who were admitted to Shenzhen Third People’s Hospital from January 2017 to January 2023 and met the inclusion criteria， and according to the results of liver biopsy， they were divided into treatment group with 41 patients （with indications for antiviral therapy） and observation group with 134 patients （without indications for antiviral therapy）. The two groups were analyzed in terms of the indicators including clinical data， imaging examinations， and serum biochemical parameters. The univariate and multivariate Logistic regression analyses were used to investigate the parameters affecting the indication for antiviral therapy， and different models for predicting the need for antiviral therapy were constructed based on related parameters. The receiver operating characteristic （ROC） curve was used to compare the diagnostic value of different models. The independent-samples t test was used for comparison of normally distributed continuous variables between groups， and the Mann-Whitney U rank sum test was used for comparison of non-normally distributed continuous variables between groups； the chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups.  Results  There were significant differences between the treatment group and the observation group in alanine aminotransferase， ferritin， total cholesterol （CHOL）， triglyceride， platelet count， liver stiffness measured by sound touch elastography （STE）， and procollagen III N-terminal propeptide （PIIIP） （all P<0.05）. The multivariate Logistic regression analysis showed that CHOL （odds ratio ［OR］=0.4， 95% confidence interval ［CI］： 0.2‍ ‍—‍ ‍1.0）， STE （OR=1.5， 95%CI： 1.0‍ ‍—‍ ‍2.1）， and PIIIP （OR=1.1， 95%CI： 1.0‍ ‍—‍ ‍1.1） were independent predictive factors for the indications for antiviral therapy. Model 1 （STE+PIIIP+CHOL）， model 2 （STE+PIIIP）， model 3 （STE+CHOL）， model 4 （PIIIP+CHOL） had an area under the ROC curve of 0.908， 0.848， 0.725， and 0.725， respectively， while STE， PIIIP， and CHOL used alone had an AUC of 0.836， 0.725， and 0.634， respectively， suggesting that model 1 had the largest AUC， with a specificity of 77.34% and a sensitivity of 96.36%， and had a significant difference compared with STE， PIIIP， CHOL， and the models 2， 3， and 4 （Z=0.21， 3.08， 3.06， 3.23， 0.89， and 0.88， all P<0.05）.  Conclusion  The noninvasive model established based on CHOL， STE， and PIIIP has a good value in predicting the need for antiviral therapy in patients with chronic HBV infection and an age of ≤30 years.

     

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    • References(16)
  • [1]
    World Health Organization. Global hepatitis report, 2017[EB/OL].( 2019-04-04)[ 2022-07-05]. https://www.who.int/hepatitis/publications/global hepatitis report2017/en/. https://www.who.int/hepatitis/publications/global hepatitis report2017/en/
    [2]
    LIU J, LIANG WN, JING WZ, et al. Countdown to 2030: Eliminating hepatitis B disease, China[J]. Bull World Health Organ, 2019, 97( 3): 230- 238. DOI: 10.2471/BLT.18.219469.
    [3]
    FATTOVICH G, BORTOLOTTI F, DONATO F. Natural history of chronic hepatitis B: Special emphasis on disease progression and prognostic factors[J]. J Hepatol, 2008, 48( 2): 335- 352. DOI: 10.1016/j.jhep.2007.11.011.
    [4]
    Chinese Society of Hepatology, Chinese Medical Association; Chinese Society of Infectious Diseases, Chinese Medical Association. Guidelines for the prevention and treatment of chronic hepatitis B(version 2022)[J]. Infect Dis Info, 2023, 36( 1): 1- 17. DOI: 10.3969/j.issn.1007-8134.2023.01.01.

    中华医学会肝病学分会, 中华医学会感染病学分会. 慢性乙型肝炎防治指南(2022年版)[J]. 传染病信息, 2023, 36( 1): 1- 17. DOI: 10.3969/j.issn.1007-8134.2023.01.01.
    [5]
    XIAO GQ, YANG JY, YAN LN. Comparison of diagnostic accuracy of aspartate aminotransferase to platelet ratio index and fibrosis-4 index for detecting liver fibrosis in adult patients with chronic hepatitis B virus infection: A systemic review and meta-analysis[J]. Hepatology, 2015, 61( 1): 292- 302. DOI: 10.1002/hep.27382.
    [6]
    EKIN N, UCMAK F, EBIK B, et al. GPR, King’s Score and S-Index are superior to other non-invasive fibrosis markers in predicting the liver fibrosis in chronic Hepatitis B patients[J]. Acta Gastroenterol Belg, 2022, 85( 1): 62- 68. DOI: 10.51821/85.1.9156.
    [7]
    LIANG XE, DAI L, YANG SL, et al. Combining routine markers improves the accuracy of transient elastography for hepatitis B cirrhosis detection[J]. Dig Liver Dis, 2016, 48( 5): 512- 518. DOI: 10.1016/j.dld.2016.02.002.
    [8]
    ZHOU XL, MA X, WANG YB, et al. Value of aspartate aminotransferase-to-platelet ratio index, fibrosis-4, and gamma-glutamyl transpeptidase-to-platelet ratio in diagnosis of liver inflammation grade in patients with chronic hepatitis B[J]. J Clin Hepatol, 2021, 37( 9): 2066- 2070. DOI: 10.3969/j.issn.1001-5256.2021.09.013.

    周新兰, 马鑫, 王雁冰, 等. APRI、FIB-4和GPR对慢性乙型肝炎肝脏炎症程度的诊断价值[J]. 临床肝胆病杂志, 2021, 37( 9): 2066- 2070. DOI: 10.3969/j.issn.1001-5256.2021.09.013.
    [9]
    GUHA IN, ROSENBERG WM. Noninvasive assessment of liver fibrosis: Serum markers, imaging, and other modalities[J]. Clin Liver Dis, 2008, 12( 4): 883- 900, x. DOI: 10.1016/j.cld.2008.07.010.
    [10]
    ZACCHERINI G, BERNARDI M. The role and indications of albumin in advanced liver disease[J]. Acta Gastroenterol Belg, 2019, 82( 2): 301- 308.
    [11]
    LIN WQ, SUN XC, FENG T, et al. Application of serum cholinesterase albumin total cholesterol level in liver function evaluation of patients with hepatitis cirrhosis[J]. J Pract Med Tech, 2020, 27( 4): 459- 461. DOI: 10.19522/j.cnki.1671-5098.2020.04.021.

    林伟强, 孙小纯, 冯涛, 等. 血清胆碱酯酶白蛋白总胆固醇水平检测在肝炎肝硬化患者肝功能评估中的应用[J]. 实用医技杂志, 2020, 27( 4): 459- 461. DOI: 10.19522/j.cnki.1671-5098.2020.04.021.
    [12]
    ZHANG LJ, SHU XC, XIAO YH. Clinical significance of serum total cholesterol, albumin, prealbum and total bile acid determination in paitients with liver cirrhosis[J]. China Pract Med, 2010, 5( 15): 15- 16. DOI: 10.14163/j.cnki.11-5547/r.2010.15.095.

    张丽娟, 舒晓春, 肖艳辉. 血清TC、ALB、PA和TBA测定在肝硬化中的临床意义[J]. 中国实用医药, 2010, 5( 15): 15- 16. DOI: 10.14163/j.cnki.11-5547/r.2010.15.095.
    [13]
    MA LJ, JI D, WANG CY, et al. A noninvasive diagnosis model for chronic hepatitis B patient based on conventional parameters[J]. Med J Chin People’s Liberation Army, 2019, 44( 10): 857- 861. DOI: 10.11855/j.issn.0577-7402.2019.10.08.

    马丽君, 纪冬, 王春艳, 等. 基于常规指标建立肝脏炎症及纤维化无创诊断模型[J]. 解放军医学杂志, 2019, 44( 10): 857- 861. DOI: 10.11855/j.issn.0577-7402.2019.10.08.
    [14]
    YANG K, PAN Y, JIN L. Clinical value on serum sCD14 level in predicting liver inflammation and fibrosis grade in patients with chronic hepatitis B[J]. J Jiujiang Univ Nat Sci Ed, 2021, 36( 3): 85- 89. DOI: 10.19717/j.cnki.jjun.2021.03.022.

    杨凯, 潘颖, 金蕾. 慢性乙型肝炎患者血清sCD14分子预测肝脏炎症和纤维化等级的临床价值[J]. 九江学院学报(自然科学版), 2021, 36( 3): 85- 89. DOI: 10.19717/j.cnki.jjun.2021.03.022.
    [15]
    ZHU L, YANG JR, HE LL, et al. Advances on the application of transient elastography in the diagnosis of liver fibrosis[J/CD]. Chin J Liver Dis(Electronic Version), 2023, 15( 3): 16- 22. DOI: 10.3969/j.issn.1674-7380.2023.03.003.

    朱璐, 杨君茹, 何玲玲, 等. 瞬时弹性成像在肝纤维化诊断中的应用研究进展[J/CD]. 中国肝脏病杂志(电子版), 2023, 15( 3): 16- 22. DOI: 10.3969/j.issn.1674-7380.2023.03.003.
    [16]
    ZHENG M, CAI WM, WENG HL, et al. ROC curve in evaluation of serum fibrosis index for diagnosing hepatic fibrosis[J]. Chin J Infect Dis, 2002, 20( 4): 225- 228. DOI: 10.3760/j.issn: 1000-6680.2002.04.009.

    郑敏, 蔡卫民, 翁红雷, 等. ROC曲线评价血清纤维化指标对诊断肝纤维化的价值[J]. 中华传染病杂志, 2002, 20( 4): 225- 228. DOI: 10.3760/j.issn:1000-6680.2002.04.009.
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