title: Serum albumin and prothrombin time before entecavir treatment in chronic hepatitis B or cirrhosis are related to amelioration of liver function after treatment.
abstract: OBJECTIVE
  Nucleotide analogs such as entecavir (ETV) ameliorate liver function in chronic hepatitis B or cirrhotic patients, but we cannot predict in which patients this will occur before ETV treatment. We aimed to develop a new pretherapeutic predictive model for the amelioration of liver function after treatment.
  
  
  METHODS
  We carried out a case-control study involving 88 chronic hepatitis B or cirrhotic patients who underwent ETV treatment at Kobe University Hospital. Blood biochemical and virological examinations were performed before and 1 year after ETV treatment. Child's score as an indicator of liver function was also evaluated at the same time. Factors associated with amelioration of Child's score 1 year after ETV treatment were assessed by multivariate analyses. A predictive model of Child's score amelioration was established.
  
  
  RESULTS
  Multivariate analyses showed that albumin (Alb) and prothrombin time (PT) before ETV treatment were independent factors for Child's score amelioration after the treatment (P=0.001 and 0.030, respectively). The decreases in Alb and PT before the treatment were significantly related to the decrease in Child's score 1 year after the treatment (P=0.001 and 0.006, respectively). The following predictive model of Child's score amelioration was developed: P=1-(1/(1+Exp(-2.215×Alb-0.058×PT+12.543))). The model could well discriminate area under ROC at 0.819 (95% confidence interval: 0.707-0.932). The optimal cutoff point was 0.185, and sensitivity and specificity were 83.3 and 73.9%, respectively.
  
  
  CONCLUSIONS
  Alb and PT before ETV treatment were related to amelioration of liver function after treatment. With our model, the probability of amelioration of liver function after treatment could be better estimated.
authors: aDepartment of Internal Medicine, Division of Gastroenterology bDepartment of Pathology, Center for Infectious Diseases cDepartment of Internal Medicine, Division of Metabolomics Research, Kobe University Graduate School of Medicine, Kobe, Japan.
authors: Masaya
authors: M
authors: Saito
authors: Yasushi
authors: Y
authors: Seo
authors: Yoshihiko
authors: Y
authors: Yano
authors: Kenji
authors: K
authors: Momose
authors: Hirotaka
authors: H
authors: Hirano
authors: Masaru
authors: M
authors: Yoshida
authors: Takeshi
authors: T
authors: Azuma
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D005260:Female; D006147:Guanine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D019694:Hepatitis B, Chronic / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D008099:Liver / Q000503:physiopathology; D008103:Liver Cirrhosis / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011517:Prothrombin Time; D012709:Serum Albumin / Q000378:metabolism*; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D015415:Biomarkers; D012709:Serum Albumin; C413685:entecavir; D006147:Guanine