Journal article
A predictive model of response to peginterferon ribavirin in chronic hepatitis C using classification and regression tree analysis
Hepatology research, Vol.40(3), pp.251-260
Received 26 May 2009; revision 25 August 2009; accepted 26 August 2009.
03/2010
DOI: 10.1111/j.1872-034X.2009.00607.x
PMID: 20070391
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 (r2 = 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.
Details
- Title: Subtitle
- A predictive model of response to peginterferon ribavirin in chronic hepatitis C using classification and regression tree analysis
- Creators
- Masayuki Kurosaki - Division of Gastroenterology and Hepatology andKotaro Matsunaga - Division of Pathology, Musashino Red Cross Hospital, TokyoItsuko Hirayama - Division of Gastroenterology and Hepatology andTomohiro Tanaka - Division of Gastroenterology and Hepatology andMitsuaki Sato - Division of Gastroenterology and Hepatology andYutaka Yasui - Division of Gastroenterology and Hepatology andNobuharu Tamaki - Division of Gastroenterology and Hepatology andTakanori Hosokawa - Division of Gastroenterology and Hepatology andKen Ueda - Division of Gastroenterology and Hepatology andKaoru Tsuchiya - Division of Gastroenterology and Hepatology andHiroyuki Nakanishi - Division of Gastroenterology and Hepatology andHiroki Ikeda - Division of Gastroenterology and Hepatology andJun Itakura - Division of Gastroenterology and Hepatology andYuka Takahashi - Division of Gastroenterology and Hepatology andYasuhiro Asahina - Division of Gastroenterology and Hepatology andMegumu Higaki - Department of Medical Science, Jikei Medical University, Tokyo, JapanNobuyuki Enomoto - First Department of Internal Medicine, University of Yamanashi, Yamanashi, andNamiki Izumi - Division of Gastroenterology and Hepatology and
- Resource Type
- Journal article
- Publication Details
- Hepatology research, Vol.40(3), pp.251-260
- Edition
- Received 26 May 2009; revision 25 August 2009; accepted 26 August 2009.
- Publisher
- Blackwell Publishing Asia
- DOI
- 10.1111/j.1872-034X.2009.00607.x
- PMID
- 20070391
- ISSN
- 1386-6346
- eISSN
- 1872-034X
- Number of pages
- 10
- Language
- English
- Date published
- 03/2010
- Academic Unit
- Gastroenterology and Hepatology; Internal Medicine
- Record Identifier
- 9984094320202771
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