Noninvasive diagnosis model for predicting significant liver inflammation in patients with chronic hepatitis B in the immune-tolerant phase

Abstract The presence of significant liver inflammation is an important indication for antiviral therapy in immune-tolerant (IT)phase with chronic hepatitis B(CHB) patients. This study aims to establish a non-invasive model to assess significant liver inflammation in the IT-phase of CHB patients. Th...

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Main Authors: Shanshan Chen, Lu Huang, Yili Chu, Jiangshan Lian, Hui Shao, Tingting Wang, Xuehan Zou, Haijun Huang
Format: Article
Language:English
Published: Nature Portfolio 2025-01-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-87756-4
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author Shanshan Chen
Lu Huang
Yili Chu
Jiangshan Lian
Hui Shao
Tingting Wang
Xuehan Zou
Haijun Huang
author_facet Shanshan Chen
Lu Huang
Yili Chu
Jiangshan Lian
Hui Shao
Tingting Wang
Xuehan Zou
Haijun Huang
author_sort Shanshan Chen
collection DOAJ
description Abstract The presence of significant liver inflammation is an important indication for antiviral therapy in immune-tolerant (IT)phase with chronic hepatitis B(CHB) patients. This study aims to establish a non-invasive model to assess significant liver inflammation in the IT-phase of CHB patients. This multicenter retrospective study included a total of 535 IT-phase CHB patients who underwent liver biopsy, and were randomly divided into a training and a validation set. In the training cohort, the relevant indices were initially screened using univariate analysis. Then the least absolute shrinkage and selection operator and multivariable logistic regression were used to identify the significant independent risk factors and establish a predictive model. A diagnostic nomogram was constructed. Calibration curves, decision curve analysis, and receiver operating characteristic curves were utilized to evaluate the performance of the nomogram. In this study, 37.0% of the patients exhibited significant liver inflammation. Baseline characteristics revealed a median age of 35.0 years, with males accounting for 51.7% of the cohort. Age, Aspartate aminotransferase (AST), Prothrombin (PT), Albumin (ALB) and Hepatitis B virus DNA (HBV DNA) were identified as independent predictors of significant liver inflammation in the immune-tolerant phase, and a nomogram was constructed based on these indicators. The predictive model demonstrated good calibration and discrimination in both the training set and the validation set (aera under the curve (AUC) of 0.741 and 0.740, respectively). The nomogram can accurately identify significant liver inflammation in immune-tolerant phase CHB patients and facilitate the early initiation of antiviral therapy, thereby reducing the need for clinical liver biopsies.
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spelling doaj-art-9deb8d666eeb42fca584a867a44b6d702025-01-26T12:28:09ZengNature PortfolioScientific Reports2045-23222025-01-011511810.1038/s41598-025-87756-4Noninvasive diagnosis model for predicting significant liver inflammation in patients with chronic hepatitis B in the immune-tolerant phaseShanshan Chen0Lu Huang1Yili Chu2Jiangshan Lian3Hui Shao4Tingting Wang5Xuehan Zou6Haijun Huang7Emergency and Critical Care Center, Department of Emergency Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College)Center for General Practice Medicine, Department of Infectious Disease, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College)Center for General Practice Medicine, Department of Infectious Disease, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College)State Key Laboratory of Infectious Diseases, Department of Infectious Disease, The First Affiliated Hospital, National Medical Center for Infectious Diseases, Zhejiang University School of Medicine, Zhejiang UniversityDepartment of Infection, Zhejiang Taizhou Hospital Affiliated to Wenzhou Medical UniversityCenter for General Practice Medicine, Department of Infectious Disease, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College)Center for General Practice Medicine, Department of Infectious Disease, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College)Center for General Practice Medicine, Department of Infectious Disease, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College)Abstract The presence of significant liver inflammation is an important indication for antiviral therapy in immune-tolerant (IT)phase with chronic hepatitis B(CHB) patients. This study aims to establish a non-invasive model to assess significant liver inflammation in the IT-phase of CHB patients. This multicenter retrospective study included a total of 535 IT-phase CHB patients who underwent liver biopsy, and were randomly divided into a training and a validation set. In the training cohort, the relevant indices were initially screened using univariate analysis. Then the least absolute shrinkage and selection operator and multivariable logistic regression were used to identify the significant independent risk factors and establish a predictive model. A diagnostic nomogram was constructed. Calibration curves, decision curve analysis, and receiver operating characteristic curves were utilized to evaluate the performance of the nomogram. In this study, 37.0% of the patients exhibited significant liver inflammation. Baseline characteristics revealed a median age of 35.0 years, with males accounting for 51.7% of the cohort. Age, Aspartate aminotransferase (AST), Prothrombin (PT), Albumin (ALB) and Hepatitis B virus DNA (HBV DNA) were identified as independent predictors of significant liver inflammation in the immune-tolerant phase, and a nomogram was constructed based on these indicators. The predictive model demonstrated good calibration and discrimination in both the training set and the validation set (aera under the curve (AUC) of 0.741 and 0.740, respectively). The nomogram can accurately identify significant liver inflammation in immune-tolerant phase CHB patients and facilitate the early initiation of antiviral therapy, thereby reducing the need for clinical liver biopsies.https://doi.org/10.1038/s41598-025-87756-4Chronic hepatitis BImmune-tolerant phaseNomogramNoninvasive diagnosis modelLiver inflammation
spellingShingle Shanshan Chen
Lu Huang
Yili Chu
Jiangshan Lian
Hui Shao
Tingting Wang
Xuehan Zou
Haijun Huang
Noninvasive diagnosis model for predicting significant liver inflammation in patients with chronic hepatitis B in the immune-tolerant phase
Scientific Reports
Chronic hepatitis B
Immune-tolerant phase
Nomogram
Noninvasive diagnosis model
Liver inflammation
title Noninvasive diagnosis model for predicting significant liver inflammation in patients with chronic hepatitis B in the immune-tolerant phase
title_full Noninvasive diagnosis model for predicting significant liver inflammation in patients with chronic hepatitis B in the immune-tolerant phase
title_fullStr Noninvasive diagnosis model for predicting significant liver inflammation in patients with chronic hepatitis B in the immune-tolerant phase
title_full_unstemmed Noninvasive diagnosis model for predicting significant liver inflammation in patients with chronic hepatitis B in the immune-tolerant phase
title_short Noninvasive diagnosis model for predicting significant liver inflammation in patients with chronic hepatitis B in the immune-tolerant phase
title_sort noninvasive diagnosis model for predicting significant liver inflammation in patients with chronic hepatitis b in the immune tolerant phase
topic Chronic hepatitis B
Immune-tolerant phase
Nomogram
Noninvasive diagnosis model
Liver inflammation
url https://doi.org/10.1038/s41598-025-87756-4
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