In:
Hepatology Research, Wiley, Vol. 40, No. 3 ( 2010-03), p. 251-260
Abstract:
Aim: Early disappearance of serum hepatitis C virus (HCV) RNA is the prerequisite for achieving sustained virological response (SVR) in peg‐interferon (PEG‐IFN) plus ribavirin (RBV) therapy for chronic hepatitis C. This study aimed to develop a decision tree model for the pre‐treatment prediction of response. Methods: Genotype 1b chronic hepatitis C treated with PEG‐IFN alpha‐2b and RBV were studied. Predictive factors of rapid or complete early virological response (RVR/cEVR) were explored in 400 consecutive patients using a recursive partitioning analysis, referred to as classification and regression tree (CART) and validated. Results: CART analysis identified hepatic steatosis ( 〈 30%) as the first predictor of response followed by low‐density‐lipoprotein cholesterol (LDL‐C) (≥100 mg/dL), age ( 〈 50 and 〈 60 years), blood sugar ( 〈 120 mg/dL), and gamma‐glutamyltransferase (GGT) ( 〈 40 IU/L) and built decision tree model. The model consisted of seven groups with variable response rates from low (15%) to high (77%). The reproducibility of the model was confirmed by the independent validation group ( r 2 = 0.987). When reconstructed into three groups, the rate of RVR/cEVR was 16% for low probability group, 46% for intermediate probability group and 75% for high probability group. Conclusions: A decision tree model that includes hepatic steatosis, LDL‐C, age, blood sugar, and GGT may be useful for the prediction of response before PEG‐IFN plus RBV therapy, and has the potential to support clinical decisions in selecting patients for therapy and may provide a rationale for treating metabolic factors to improve the efficacy of antiviral therapy.
Type of Medium:
Online Resource
ISSN:
1386-6346
,
1872-034X
DOI:
10.1111/hep.2010.40.issue-3
DOI:
10.1111/j.1872-034X.2009.00607.x
Language:
English
Publisher:
Wiley
Publication Date:
2010
detail.hit.zdb_id:
2006439-1
detail.hit.zdb_id:
1387041-5
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