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- Title
A predictive model of response to peginterferon ribavirin in chronic hepatitis C using classification and regression tree analysis.
- Authors
Kurosaki, Masayuki; Matsunaga, Kotaro; Hirayama, Itsuko; Tanaka, Tomohiro; Sato, Mitsuaki; Yasui, Yutaka; Tamaki, Nobuharu; Hosokawa, Takanori; Ueda, Ken; Tsuchiya, Kaoru; Nakanishi, Hiroyuki; Ikeda, Hiroki; Itakura, Jun; Takahashi, Yuka; Asahina, Yasuhiro; Higaki, Megumu; Enomoto, Nobuyuki; Izumi, Namiki
- 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.
- Subjects
HEPATITIS C; RNA; RIBAVIRIN; INTERFERONS; REGRESSION analysis
- Publication
Hepatology Research, 2010, Vol 40, Issue 3, p251
- ISSN
1386-6346
- Publication type
Article
- DOI
10.1111/j.1872-034X.2009.00607.x