A decision-making model for prediction of a stable disease course in chronic hepatitis B patients
Abstract Patients with chronic hepatitis B (CHB) are regularly monitored for HBV DNA and liver enzymes in order to assess disease progression and the need for antiviral therapy. Identifying patients with a stable course of disease can potentially prolong the intervals between visits, withhold unnece...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2023-12-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-023-50460-2 |
| _version_ | 1797371233241661440 |
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| author | Imri Ofri Noam Peleg Moshe Leshno Amir Shlomai |
| author_facet | Imri Ofri Noam Peleg Moshe Leshno Amir Shlomai |
| author_sort | Imri Ofri |
| collection | DOAJ |
| description | Abstract Patients with chronic hepatitis B (CHB) are regularly monitored for HBV DNA and liver enzymes in order to assess disease progression and the need for antiviral therapy. Identifying patients with a stable course of disease can potentially prolong the intervals between visits, withhold unnecessary tests and save money. Accordingly, we aimed to find predictors for a stable disease course in patients with CHB. 579 patients with CHB, who were followed in a tertiary referral center between January 2004–December 2018, were retrospectively analyzed. Patients with low and steady viral load titer (< 2000 IU/ml) and normal ALT levels (< 40 IU/ml) in 6 consecutive clinic encounters were considered to have a stable course of CHB. A stepwise multivariate logistic regression analysis and a decision tree model were used to identify predictors of a stable disease course. Following exclusion of ineligible patients, a total of 220 patients were included in the final analysis. 64/220 patients had a stable disease course. Patients with a stable disease were older (62.99 ± 12.36 Vs. 54.07 ± 13.64, p < 0.001) with a higher percentage of women (53% vs. 38%) and had lower baseline levels of AST, ALT and viral load (VL). In a multivariate analysis, age (OR 0.94, 95% CI 0.91–0.98), baseline ALT (OR 1.06, 95% CI 1.01–1.1) and VL (OR 1.05 95% CI 1.02–1.08), were significantly associated with a stable disease. In a decision tree model, patients 46–67 years old, with baseline VL < 149 IU/mL and ALT < 40 IU/mL had the best probability (91%) for a stable disease course over 4.4 ± 2.2 years. We conclude that integrating patients’ age with baseline VL and ALT can predict a stable disease course in patients with CHB off treatment. |
| first_indexed | 2024-03-08T18:15:56Z |
| format | Article |
| id | doaj.art-c0d3d96aa21846a79113f60ec2a2b514 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-03-08T18:15:56Z |
| publishDate | 2023-12-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-c0d3d96aa21846a79113f60ec2a2b5142023-12-31T12:10:01ZengNature PortfolioScientific Reports2045-23222023-12-011311810.1038/s41598-023-50460-2A decision-making model for prediction of a stable disease course in chronic hepatitis B patientsImri Ofri0Noam Peleg1Moshe Leshno2Amir Shlomai3Department of Medicine D and the Laboratory of Liver Research, Rabin Medical Center, Beilinson HospitalThe Faculty of Medicine, Tel-Aviv UniversityThe Coller Faculty of Management, Tel-Aviv UniversityDepartment of Medicine D and the Laboratory of Liver Research, Rabin Medical Center, Beilinson HospitalAbstract Patients with chronic hepatitis B (CHB) are regularly monitored for HBV DNA and liver enzymes in order to assess disease progression and the need for antiviral therapy. Identifying patients with a stable course of disease can potentially prolong the intervals between visits, withhold unnecessary tests and save money. Accordingly, we aimed to find predictors for a stable disease course in patients with CHB. 579 patients with CHB, who were followed in a tertiary referral center between January 2004–December 2018, were retrospectively analyzed. Patients with low and steady viral load titer (< 2000 IU/ml) and normal ALT levels (< 40 IU/ml) in 6 consecutive clinic encounters were considered to have a stable course of CHB. A stepwise multivariate logistic regression analysis and a decision tree model were used to identify predictors of a stable disease course. Following exclusion of ineligible patients, a total of 220 patients were included in the final analysis. 64/220 patients had a stable disease course. Patients with a stable disease were older (62.99 ± 12.36 Vs. 54.07 ± 13.64, p < 0.001) with a higher percentage of women (53% vs. 38%) and had lower baseline levels of AST, ALT and viral load (VL). In a multivariate analysis, age (OR 0.94, 95% CI 0.91–0.98), baseline ALT (OR 1.06, 95% CI 1.01–1.1) and VL (OR 1.05 95% CI 1.02–1.08), were significantly associated with a stable disease. In a decision tree model, patients 46–67 years old, with baseline VL < 149 IU/mL and ALT < 40 IU/mL had the best probability (91%) for a stable disease course over 4.4 ± 2.2 years. We conclude that integrating patients’ age with baseline VL and ALT can predict a stable disease course in patients with CHB off treatment.https://doi.org/10.1038/s41598-023-50460-2 |
| spellingShingle | Imri Ofri Noam Peleg Moshe Leshno Amir Shlomai A decision-making model for prediction of a stable disease course in chronic hepatitis B patients Scientific Reports |
| title | A decision-making model for prediction of a stable disease course in chronic hepatitis B patients |
| title_full | A decision-making model for prediction of a stable disease course in chronic hepatitis B patients |
| title_fullStr | A decision-making model for prediction of a stable disease course in chronic hepatitis B patients |
| title_full_unstemmed | A decision-making model for prediction of a stable disease course in chronic hepatitis B patients |
| title_short | A decision-making model for prediction of a stable disease course in chronic hepatitis B patients |
| title_sort | decision making model for prediction of a stable disease course in chronic hepatitis b patients |
| url | https://doi.org/10.1038/s41598-023-50460-2 |
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