Development and evaluation of a baseline-event-anticipation score for hepatitis delta.
Bottom Line: The baseline-event-anticipation score (BEA score) was developed based on variables associated with the development of liver-related clinical complications.Age, region of origin, presence of cirrhosis, albumin, INR, hyperbilirubinemia and thrombocytopenia were all associated with the development of an event in the training cohort.Delta hepatitis is associated with a very severe long-term outcome.
Affiliation: Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany; German Center for Infection Research (DZIF), Partner Side HepNet Study-House, Hannover, Germany.Show MeSH
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Mentions: Only patients with detectable HBsAg and either anti-HDV antibodies (anti-HDV Ab) or HDV-RNA for more than 6 months were included. Patients with undetectable HDV-RNA were considered to have chronic hepatitis delta if they repeatedly showed biochemical signs of hepatitis (e.g. transaminases increased 1.5-fold above the upper limit of normal ULN) in the absence of significant HBV replication. Patients were required to have an available follow-up of at least 18 months with a minimum of three visits at our centre and no longer than 4 years between consecutive visits. Those patients who had undergone an OLT before the first observation (baseline) or less than 18 months after baseline were excluded. Additional exclusion criteria were human immunodeficiency virus (HIV) co-infection, active alcohol abuse or drug addiction, evidence of metabolic, autoimmune or genetic liver disease and ongoing therapies that could interfere with either the liver function or the viral replication (e.g. chemotherapy). The system used for patient selection and inclusion is summarized in Fig. 1a.
Affiliation: Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany; German Center for Infection Research (DZIF), Partner Side HepNet Study-House, Hannover, Germany.