Establishment of a predictive model for early virologic response in previously untreated chronic hepatitis B patients treated with telbivudine / 临床肝胆病杂志

ABSTRACT

ObjectiveTo investigate the establishment of a predictive model for early virologic response in previously untreated chronic hepatitis B (CHB) patients treated with telbivudine, since early virologic response can predict the long-term efficacy of nucleotide analogues. MethodsA total of 135 CHB patients who visited Mengchao Hepatobiliary Hospital of Fujian Medical University from January 2007 to August 2014 were enrolled and treated with telbivudine (600 mg qd) for at least 24 weeks. Follow-up was performed once every 2 weeks, and the patients′ baseline data and data measured during treatment were recorded. The t-test was used for comparison of continuous data between groups, the chi-square test was used for comparison of categorical data between groups, and the Cox proportional hazards regression model was used to analyze the influencing factors for early virologic response and establish the predictive model. ResultsThe patients without a family history of hepatitis B virus (HBV) infection (P=0.000 3) and with high baseline levels of total bilirubin (TBil) (P=0.002 6) and aspartate aminotransferase (AST) (P=0.007 4) and a low HBV DNA load (P=0.002 3) tended to show early virologic response. The predictive model was established based on these variables, and the risk score (R) of CHB patients was calculated. The CHB patients with R＞0.85 were more likely to achieve early virologic response. ConclusionThe model established based on the four variables of family history, baseline TBil level, baseline AST level, and HBV DNA level can well predict early virologic response in previously untreated CHB patients treated with telbivudine.