Baseline and change in platelet count, AST/ALT ratio, bilirubin, albumin values found predictive
MONDAY, Nov. 7 (HealthDay News) -- Clinical outcomes of patients with advanced hepatitis C can be predicted by models using baseline values of routine laboratory variables along with magnitude of change in their values over time, according to a study published in the November issue of Hepatology.
Marc G. Ghany, M.D., from the National Institutes of Health in Bethesda, Md., and colleagues developed two models for predicting clinical decompensation (based on 470 patients with 60 events) and liver-related death/liver transplant (based on 483 patients with 79 events) in advanced hepatitis C. Participants received no treatment and had two or more years of follow-up without a clinical outcome. The models were constructed using baseline values of routinely available laboratory variables (platelet count, aspartate aminotransferase [AST]/alanine aminotransferase [ALT] ratio, total bilirubin, and albumin) along with changes in their values (categorized as stable, mild, or severe) during follow-up. Cumulative incidence and predictors of clinical outcome were determined.
The investigators found that the baseline values of all four variables predicted decompensation. Marked worsening of laboratory values over two years was associated with a trend toward increasing outcomes, especially in patients with abnormal baseline values. The model which best predicted clinical decompensation included baseline platelet count, bilirubin, AST/ALT ratio, with severe worsening of platelet count, bilirubin, and albumin. The model which best predicted liver-related outcomes included baseline platelet count and albumin, with severe worsening of AST/ALT ratio and albumin.
"The outcome of advanced chronic hepatitis C was dependent not only on the value of the laboratory parameter at initial presentation, but also on the magnitude of the change in the particular parameter over time," the authors write.
One of the study authors disclosed financial ties with the pharmaceutical industry. Another author disclosed financial ties to Hoffmann-La Roche (now Genentech), which partially funded the study.
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