title: Artificial neural network accurately predicts hepatitis B surface antigen seroclearance.
abstract: OBJECTIVE
  Hepatitis B surface antigen (HBsAg) seroclearance and seroconversion are regarded as favorable outcomes of chronic hepatitis B (CHB). This study aimed to develop artificial neural networks (ANNs) that could accurately predict HBsAg seroclearance or seroconversion on the basis of available serum variables.
  
  
  METHODS
  Data from 203 untreated, HBeAg-negative CHB patients with spontaneous HBsAg seroclearance (63 with HBsAg seroconversion), and 203 age- and sex-matched HBeAg-negative controls were analyzed. ANNs and logistic regression models (LRMs) were built and tested according to HBsAg seroclearance and seroconversion. Predictive accuracy was assessed with area under the receiver operating characteristic curve (AUROC).
  
  
  RESULTS
  Serum quantitative HBsAg (qHBsAg) and HBV DNA levels, qHBsAg and HBV DNA reduction were related to HBsAg seroclearance (P<0.001) and were used for ANN/LRM-HBsAg seroclearance building, whereas, qHBsAg reduction was not associated with ANN-HBsAg seroconversion (P = 0.197) and LRM-HBsAg seroconversion was solely based on qHBsAg (P = 0.01). For HBsAg seroclearance, AUROCs of ANN were 0.96, 0.93 and 0.95 for the training, testing and genotype B subgroups respectively. They were significantly higher than those of LRM, qHBsAg and HBV DNA (all P<0.05). Although the performance of ANN-HBsAg seroconversion (AUROC 0.757) was inferior to that for HBsAg seroclearance, it tended to be better than those of LRM, qHBsAg and HBV DNA.
  
  
  CONCLUSIONS
  ANN identifies spontaneous HBsAg seroclearance in HBeAg-negative CHB patients with better accuracy, on the basis of easily available serum data. More useful predictors for HBsAg seroconversion are still needed to be explored in the future.
authors.affiliation: Department of Infection and Liver Diseases, Liver Research Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China; Department of Medicine, the University of Hong Kong, Queen Mary Hospital, Hong Kong, China.
authors.forename: Ming-Hua
authors.initials: MH
authors.lastname: Zheng
authors.affiliation: Department of Medicine, the University of Hong Kong, Queen Mary Hospital, Hong Kong, China; State Key Laboratory for Liver Research, the University of Hong Kong, Queen Mary Hospital, Hong Kong, China.
authors.forename: Wai-Kay
authors.initials: WK
authors.lastname: Seto
authors.affiliation: Department of Infection and Liver Diseases, Liver Research Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
authors.forename: Ke-Qing
authors.initials: KQ
authors.lastname: Shi
authors.affiliation: Department of Medicine, the University of Hong Kong, Queen Mary Hospital, Hong Kong, China; State Key Laboratory for Liver Research, the University of Hong Kong, Queen Mary Hospital, Hong Kong, China.
authors.forename: Danny Ka-Ho
authors.initials: DK
authors.lastname: Wong
authors.affiliation: Department of Medicine, the University of Hong Kong, Queen Mary Hospital, Hong Kong, China; State Key Laboratory for Liver Research, the University of Hong Kong, Queen Mary Hospital, Hong Kong, China.
authors.forename: James
authors.initials: J
authors.lastname: Fung
authors.affiliation: Department of Medicine, the University of Hong Kong, Queen Mary Hospital, Hong Kong, China.
authors.forename: Ivan Fan-Ngai
authors.initials: IF
authors.lastname: Hung
authors.affiliation: Department of Nursing Studies, the University of Hong Kong, Queen Mary Hospital, Hong Kong, China.
authors.forename: Daniel Yee-Tak
authors.initials: DY
authors.lastname: Fong
authors.affiliation: Department of Medicine, the University of Hong Kong, Queen Mary Hospital, Hong Kong, China.
authors.forename: John Chi-Hang
authors.initials: JC
authors.lastname: Yuen
authors.affiliation: Department of Medicine, the University of Hong Kong, Queen Mary Hospital, Hong Kong, China.
authors.forename: Teresa
authors.initials: T
authors.lastname: Tong
authors.affiliation: Department of Medicine, the University of Hong Kong, Queen Mary Hospital, Hong Kong, China; State Key Laboratory for Liver Research, the University of Hong Kong, Queen Mary Hospital, Hong Kong, China.
authors.forename: Ching-Lung
authors.initials: CL
authors.lastname: Lai
authors.affiliation: Department of Medicine, the University of Hong Kong, Queen Mary Hospital, Hong Kong, China; State Key Laboratory for Liver Research, the University of Hong Kong, Queen Mary Hospital, Hong Kong, China.
authors.forename: Man-Fung
authors.initials: MF
authors.lastname: Yuen
mesh_terms: D003710:Demography; D005260:Female; D006514:Hepatitis B Surface Antigens / Q000097:blood* / Q000276:immunology*; D019694:Hepatitis B, Chronic / Q000097:blood* / Q000276:immunology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016571:Neural Networks, Computer; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D006514:Hepatitis B Surface Antigens