Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Beinhardt, S; Payer, BA; Datz, C; Strasser, M; Maieron, A; Dorn, L; Grilnberger-Franz, E; Dulic-Lakovic, E; Stauber, R; Laferl, H; Aberle, JH; Holzmann, H; Krall, C; Vogel, W; Ferenci, P; Hofer, H.
A diagnostic score for the prediction of spontaneous resolution of acute hepatitis C virus infection.
J Hepatol. 2013; 59(5):972-977
Doi: 10.1016/j.jhep.2013.06.028
Web of Science
PubMed
FullText
FullText_MUG
- Co-Autor*innen der Med Uni Graz
- Stauber Rudolf
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- Abstract:
- IL28B polymorphisms, jaundice, decline in HCV-RNA, IP-10, and gender have been proposed to be indicative of spontaneous clearance of acute hepatitis C virus infection. The aim of this study was to define a score enabling the discrimination of patients with spontaneous clearance of HCV from those with development of viral persistence and need for early antiviral treatment. 136 patients (74 male; 35 ± 15 years) were analyzed. From variables predictive of spontaneous clearance, calculated by univariate analysis, three scores were built. Analogous cut-offs were evaluated by computing area under the receiver operating characteristic curves. Candidate variables and cut-offs were: (I) presence of IL28B C/C (p=0.027), (II) age (p=0.031; cut-off: 35 years), (III) peak-bilirubin (p=0.018; cut-off: 6 mg/dl), (IV) HCV-RNA decline within 4 weeks (p<0.001;cut-off: >2.5 log), (V) serum IP-10 (p=0.003; cut-off: 546 pg/ml), (VI) presence of CD4(+) Th1 cells (p=0.024). Each variable was allocated to 0 or 1 point, an HCV-RNA decline of ≥ 1 log 10 but <2.5 log 10 to 1 point, a decline of ≥ 2.5 log 10 to 2 points. Three scores were evaluated (Score 1: I-IV; Score 2: I-V; Score 3: I-VI). A cut-off of ≥ 3 points out of 5 in Score 1 (AUROC: 0.82; DeLong 95% CI: 0.76-0.93) predicted spontaneous clearance with a sensitivity of 71% (95% CI: 0.53-0.86) and specificity of 87% (95% CI: 0.73-0.95). PPV and NPV were 79% and 82%. Corresponding findings for Score 2 including IP-10 (AUROC: 0.93; DeLong 95% CI: 0.86-0.93) at a cut-off of ≥ 4 were: sensitivity 81%, specificity 95% (PPV: 100%; NPV: 77%). A cut-off of ≥ 5 in Score 3 (AUROC: 0.98; DeLong 95% CI: 0.95-1.0) predicted spontaneous resolution with a sensitivity of 75% and specificity of 100% (PPV: 100%; NPV: 88%). The scores enable a reliable discrimination between AHC-patients with high potential for spontaneous clearance from candidates for early therapeutic intervention due to marginal chance of spontaneous resolution. Copyright © 2013 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
- Find related publications in this database (using NLM MeSH Indexing)
- Acute Disease -
- Adolescent -
- Adult -
- Age Factors -
- Aged -
- Aged, 80 and over -
- Antiviral Agents - therapeutic use
- Bilirubin - blood
- Chemokine CXCL10 - blood
- Female -
- Hepacivirus - genetics
- Hepatitis C - blood
- Humans -
- Interleukins - genetics
- Male -
- Middle Aged -
- Polymorphism, Genetic - genetics
- Predictive Value of Tests -
- RNA, Viral - blood
- Remission, Spontaneous -
- Retrospective Studies -
- Sensitivity and Specificity -
- Watchful Waiting -
- Young Adult -
- Find related publications in this database (Keywords)
- Newly acquired HCV
- Spontaneous clearance
- Score
- IL28B
- IP-10