Predicting hepatitis B virus (HBV) surface antigen seroclearance in HBV e antigen-negative patients with chronic hepatitis B: External validation of a scoring system
Journal
Journal of Infectious Diseases
Journal Volume
211
Journal Issue
10
Pages
1566-1573
Date Issued
2015
Author(s)
Liu J.
Yang H.-I.
Lee M.-H.
Batrla-Utermann R.
Jen C.-L.
Lu S.-N.
Wang L.-Y.
You S.-L.
Chen C.-J.
Abstract
Background. Hepatitis B virus (HBV) surface antigen (HBsAg) seroclearance is the ultimate serological end point in chronic hepatitis B. This study aimed to develop and validate a prediction score for spontaneous HBsAg seroclearance in HBV e antigen (HBeAg)-negative patients with chronic hepatitis B due to HBV genotype B or C. Methods. The development cohort included 2491 untreated participants from the community-based REVEAL-HBV study, who were HBeAg negative, anti-hepatitis C virus negative, and cirrhosis free. The independent validation cohort consisted of 1934 hospital-based individuals from the National Taiwan University Hospital. Clinical markers included in the model were age and serum HBV DNA and HBsAg levels. Cox proportional hazards regression models were used to create the prediction model. Results. A prediction score ranging from 0 to 27 was developed. Predicted probabilities of 5-and 10-year HBsAg seroclearance ranged from 0.95% to 30.49% and from 2.58% to 62.52%, respectively. When applied to the independent validation cohort, the areas under the receiver operating characteristic curves for the 5-and 10-year prediction of HBsAg seroclearance in the validation cohort were 0.82 (95% confidence interval [CI],. 76-.88) and 0.74 (95% CI,. 70-.78). Model fit was still adequate, according to Hosmer-Lemeshow goodness of fit tests. Conclusions. A clinically applicable prediction score for HBsAg seroclearance was developed and externally validated. This model can assist clinicians in further stratifying risk groups. ? 2014 The Author.
SDGs
Other Subjects
hepatitis B surface antigen; hepatitis B(e) antigen; hepatitis C antibody; virus DNA; hepatitis B surface antigen; hepatitis B(e) antigen; adult; age distribution; antigen detection; Article; chronic hepatitis B; cohort analysis; controlled study; female; Hepatitis B virus genotype B; Hepatitis B virus genotype C; human; liver cirrhosis; major clinical study; male; middle aged; plasma clearance; priority journal; receiver operating characteristic; risk assessment; scoring system; Taiwan; university hospital; validation process; virus load; aged; blood; classification; genetics; genotype; Hepatitis B virus; Hepatitis B, Chronic; prognosis; severity of illness index; validation study; virology; Adult; Aged; Cohort Studies; DNA, Viral; Female; Genotype; Hepatitis B e Antigens; Hepatitis B Surface Antigens; Hepatitis B virus; Hepatitis B, Chronic; Humans; Male; Middle Aged; Prognosis; Severity of Illness Index; Taiwan
Publisher
Oxford University Press
Type
journal article