Nomogram for evaluating obvious liver inflammation in treatment-naïve HBeAg positive chronic hepatitis B virus infection patients with normal ALT

Figures & data

Table 1. Baseline characteristics of model cohort and validation cohort.

	All	Model cohort	Validation cohort	Statistics	P value
	(n = 380)	(n = 292)	(n = 88)
Sex
Male,n(%)	210(55.26)	170(58.22)	40(45.45)	4.46(χ^2)	0.035
Female,n(%)	170(44.74)	122(41.78)	48(54.55)
Age (years)	35.24 ± 9.79	34.26 ± 9.77	38.47 ± 9.19	−3.58(t)	<0.001
Log10qHBsAg (IU/ml)	3.43 ± 0.97	3.42 ± 0.96	3.46 ± 1.01	−0.40(t)	0.691
Log10qHBeAg (S/CO)	2.46 ± 1.04	2.56 ± 0.97	2.12 ± 1.19	3.14(t)	0.002
Log10qHBV DNA (IU/ml)	6.65 ± 1.66	6.73 ± 1.55	6.39 ± 1.96	1.46(t)	0.146
ALT (U/L)	28.0(21.5,33.5)	28.3(21.6,33.5)	27.1(20.9,33.3)	0.63(Z)	0.526
AST (U/L)	22.9(19.4,26.9)	22.7(19.3,26.3)	24.0(20.0,28.0)	1.62(Z)	0.105
TBIL (umol/l)	12.5(9.5,16.2)	12.7(9.5,16.1)	12.0(9.6,17.0)	0.71(Z)	0.480
ALB (g/L)	45.7(43.2,48.0)	45.7(43.5,48.2)	45.8(43.0,47.0)	1.42(Z)	0.156
WBC (10^9/L)	5.8(4.8,6.7)	5.8(5.0,6.8)	5.7(4.2,6.5)	1.90(Z)	0.058
PLT(10^9/L)	205.58 ± 55.12	203.23 ± 52.78	213.37 ± 61.94	−1.51(t)	0.131
PTA (%)	89.71 ± 10.14	87.36 ± 8.90	96.02 ± 10.61	−6.74(t)	<0.001

Note: Data are quartile division or mean±SD for continuous factors. The n (%) was used for categorical factors.

Abbreviations: qHBsAg, quantitative HBsAg; qHBeAg,quantitative HBeAg; ALT, alanine aminotransferase; AST, aspartate aminotransferase; PTA, prothrombin activity. WBC, white blood cell; TBil, total bilirubin; ALB, albumin; PLT, platelet.

Table 2. Comparison between non-significant liver inflammation group and significant liver inflammation group in the model cohort.

	Model cohort	non significant liver inflammation group	Significant liver inflammation group	Statistics	P value
	(n = 292)	(n = 204)	(n = 88)
Sex
Male,n(%)	170(58.22)	127(62.25)	43(48.86)	4.53(χ^2)	0.033
Female,n(%)	122(41.78)	77(37.75)	45(51.14)
Age (years)	34.26 ± 9.77	32.69 ± 8.81	37.92 ± 10.92	−3.97(t)	0.000
Log10qHBsAg (IU/ml)	3.42 ± 0.96	3.43 ± 1.01	3.38 ± 0.81	0.46(t)	0.648
Log10qHBeAg (S/CO)	2.56 ± 0.97	2.76 ± 0.85	2.08 ± 1.05	5.38(t)	0.000
Log10qHBV DNA (IU/ml)	6.73 ± 1.55	6.96 ± 1.50	6.19 ± 1.55	3.92(t)	0.000
ALT(U/L)	28.3(21.6,33.5)	27.5(21.4,33.1)	29.2(23.7,34.8)	1.85(Z)	0.064
AST(U/L)	22.7(19.3,26.3)	21.5(18.4,24.5)	25.3(21.7,30.3)	5.66(Z)	<0.001
TBIL(umol/l)	12.7(9.5,16.1)	12.9(9.6,16.5)	12.6(9.5,15.2)	1.03(Z)	0.304
ALB (g/L)	45.7(43.5,48.2)	46.2(44.1,48.4)	45.0(42.2,47.3)	2.79(Z)	0.005
WBC (10^9/L)	5.8(5.0,6.8)	5.8(5.0,6.8)	5.8(4.9,6.7)	0.38(Z)	0.707
PLT (10^9/L)	203.23 ± 52.78	211.96 ± 52.47	183.01 ± 47.99	4.44(t)	0.000
PTA (%)	87.36 ± 8.90	87.30 ± 9.25	87.48 ± 8.12	−0.14(t)	0.885

Note: Data are quartile division or mean±SD for continuous factors. The n (%) was used for categorical factors. Abbreviations: qHBsAg, quantitative HBsAg; qHBeAg, quantitative HBeAg; ALT, alanine aminotransferase; AST, aspartate aminotransferase; PTA, prothrombin activity. WBC, white blood cell; TBil, total bilirubin; ALB, albumin; PLT, platelet.

Table 3. Univariate logistic regression analysis of factors for obvious liver inflammation in the model cohort.

						95%CI for OR
	b	stb	Wald	P	OR	Lower	Upper
Sex	0.55	0.26	4.49	0.034	1.73	1.04	2.86
Age (years)	0.06	0.01	16.63	<0.001	1.06	1.03	1.09
Log10qHBsAg (IU/ml)	−0.06	0.14	0.18	0.675	0.94	0.76	1.24
Log10qHBeAg (S/CO)	−0.69	0.13	27.44	<0.001	0.50	0.39	0.65
Log10HBV DNA (IU/ml)	−0.30	0.08	13.54	<0.001	0.74	0.63	0.87
ALT(U/L)	0.03	0.02	3.68	0.055	1.03	1.00	1.07
AST(U/L)	0.14	0.03	30.57	<0.001	1.15	1.10	1.21
TBIL(umol/l)	−0.03	0.02	2.28	0.131	0.97	0.93	1.01
ALB (g/L)	−0.04	0.02	3.16	0.076	0.96	0.91	1.00
WBC(10^9/L)	−0.02	0.09	0.07	0.789	0.98	0.82	1.16
PLT(10^9/L)	−0.01	0.00	17.60	<0.001	0.99	0.98	0.99
PTA (%)	0.00	0.02	0.02	0.884	1.00	0.97	1.03

Abbreviations: qHBsAg, quantitative HBsAg; qHBeAg, quantitative HBeAg; ALT, alanine aminotransferase; AST, aspartate aminotransferase; PTA, prothrombin activity. WBC, White blood cell; TBil, total bilirubin; ALB, albumin; PLT, platelet.

Table 4. Multivariate logistic analysis of significant liver inflammation in the model cohort.

						95%CI for OR
	b	stb	Wald	P	OR	Lower	Upper
Intercep	−0.91	1.00	0.82	0.364
Log10qHBeAg (S/CO)	−0.41	0.15	7.56	0.006	0.67	0.50	0.89
AST(U/L)	0.11	0.03	15.21	0.000	1.11	1.05	1.17
PLT(10^9/L)	−0.01	0.00	5.71	0.017	0.99	0.99	1.00

Abbreviations: qHBeAg, quantitative HBeAg; AST, aspartate aminotransferase; PLT, platelet.

Table 5. Point assignment and risk of the scoring system on significant liver inflammation.

AST (U/L)	Points	PLT (10^9/L)	Points	Log10qHBeAg (S/CO)	Points	Total Points	Risk
5	0	100	7	0	4	6	0.05
10	1	150	6	0.5	3	8	0.1
15	3	200	5	1	3	10	0.2
20	4	250	4	1.5	2	12	0.4
25	6	300	3	2	2	13	0.5
30	7	350	2	2.5	1	14	0.5
35	9	400	1	3	1	16	0.7
40	10	450	0	3.5	0	18	0.8
						20	0.9

Abbreviations: qHBeAg, quantitative HBeAg; AST, aspartate aminotransferase; PLT, platelet.

Figure 1. Nomogram for predicting significant liver inflammation based on model cohort. Abbreviations: qHBeAg, quantitative HBeAg; AST, aspartate aminotransferase; PLT, platelet.

Figure 2. The calibration curve of significant liver inflammation nomogram on the model cohort. Predicted and actual liver inflammation probability were respectively plotted on the X-axis and the Y-axis. The 45-degree dashed lines through the coordinate origin represent the excellent calibration models. Bootstraps with 200 resamples were adopted.

Figure 3. The calibration curve of significant liver inflammation nomogram on the validation cohort. Bootstraps with 200 resamples were adopted.

Data availability statement

The data used to support the findings of this study are available from the corresponding author upon request.