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A noninvasive model discriminating significant histological changes in treatment-naive chronic hepatitis B patients with normal ALT

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机构: [1]Shanghai Jiao Tong Univ, Ruijin Hosp, Dept Infect Dis, Sch Med, 197 Ruijin 2nd Rd, Shanghai 200025, Peoples R China [2]Shanghai Jiao Tong Univ, Tongren Hosp, Dept Infect Dis, Phase Clin Trial Unit 1,Sch Med, 1111 XianXia Rd, Shanghai 200336, Peoples R China
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关键词: Hepatitis B virus Alanine aminotransferase Liver stiffness Liver histology

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Background Traditionally part of chronic hepatitis B (CHB) patients with normal alanine aminotransferase (ALT) are recommended to antiviral therapy referring to liver biopsy. However, liver biopsy is an invasive method with various potential complications. A noninvasive model was established in the study to evaluate liver histology and to identify the need of antiviral therapy.Methods A total of 614 liver biopsied CHB patients with ALT less than upper limit of normal from 2 centers were retrospectively analyzed. They were divided into a training cohort and a validation cohort. A noninvasive model to predict the significant liver histological changes was established and validated.Results The results of analysis showed that ALT, Age, platelet (PLT) and liver stiffness (LS) were independent risk factors for significant liver injury. The model was established based on the 4 indexes, with the area under the curve of 0.85 and 0.87 in training cohort and validation cohort. Meanwhile, 2 cut-off scores were selected. By applying the low cut-off score (- 0.207), patients without significant liver injury could be identified with high accuracy, with negative predictive value of 72.7% and 73.7% in training and validation cohorts. By applying the high cut-off score (0.537), the presence of significant liver injury could be diagnosed with high accuracy, with positive predictive value of 90.3% and 88.8% in the training and validation cohorts. By applying the model, liver biopsy would have been avoided in 87.6% (538/614) patients, with correct prediction in 87.9% (473/538).Conclusion The novel noninvasive model composed of ALT, Age, PLT, LS can correctly assess liver histology in CHB patient with normal ALT, which helps to determine the need of antiviral therapy without liver biopsy.

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出版当年[2022]版:
大类 | 3 区 医学
小类 | 3 区 病毒学
最新[2023]版:
大类 | 3 区 医学
小类 | 2 区 病毒学
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出版当年[2021]版:
Q2 VIROLOGY
最新[2023]版:
Q2 VIROLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2021版] 出版当年五年平均 出版前一年[2020版] 出版后一年[2022版]

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第一作者机构: [1]Shanghai Jiao Tong Univ, Ruijin Hosp, Dept Infect Dis, Sch Med, 197 Ruijin 2nd Rd, Shanghai 200025, Peoples R China
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