Combined Liver Stiffness and Α-fetoprotein Further beyond the Sustained Virologic Response Visit as Predictors of Long-Term Liver-Related Events in Patients with Chronic Hepatitis C
Table 4
Cox regression analysis for prediction of LREs (n = 12, multivariate analysis) after year 3 post-SVR.
Variables
n/n
Crude HR
(95% CI)
value
Adjusted HR
(95% CI)
value
Age, ≥65 vs. <65 years (TW0)
15/402
1.055
0.997–1.117
0.064
2.362
0.643–8.675
0.195
Sex, male vs female
15/402
0.563
0.200–1.583
0.276
Body mass index, kg/m2 (TW0)
15/402
1.054
0.915–1.214
0.467
HCV RNA log10, IU/mL (TW0)
15/402
1.000
1.000–1.000
0.430
Genotype, 1 vs non-1
15/402
1.031
0.374–2.845
0.952
Clinical cirrhosis (TW0)
15/402
2.494
0.702–8.862
0.158
AST, U/L (TW0)
15/401
1.009
1.004–1.013
<0.001
ALT, U/L (TW0)
15/402
1.005
1.000–1.009
0.029
AFP, ng/mL (TW0)
15/395
0.997
0.979–1.015
0.729
Albumin, g/dL (TW0)
15/396
0.327
0.098–1.096
0.070
Bilirubin, mg/dL (TW0)
15/402
2.478
0.811–7.574
0.111
eGFR, mL/min/1.73 m2 (TW0)
15/402
0.995
0.983–1.008
0.478
HbA1c, % (TW0)
15/398
1.048
0.627–1.754
0.857
WBCs, /μL (TW0)
15/402
0.999
0.999–1.000
0.010
Hemoglobin, g/dL (TW0)
15/402
0.780
0.550–1.105
0.163
Platelets, ×103/μL (TW0)
15/402
0.983
0.972–0.995
0.004
INR (TW0)
15/401
213.579
0.375–1200
0.098
AST, U/L (SVR)
15/401
1.022
1.009–1.036
0.001
ALT, U/L (SVR)
15/402
1.009
0.994–1.024
0.236
AFP, ng/mL (SVR)
15/392
1.050
1.024–1.076
<0.001
AFP, ng/mL (Y3PSVR)
13/306
1.021
1.011–1.030
<0.001
1.017
1.001–1.034
0.034
AFP decline, % (from SVR to Y3PSVR)
13/305
0.930
0.897–0.963
<0.001
Albumin, g/dL (SVR)
15/394
1.482
0.279–7.880
0.645
Bilirubin, mg/dL (SVR)
15/398
1.181
0.309–4.511
0.808
eGFR, mL/min/1.73 m2 (SVR)
15/394
0.993
0.980–1.006
0.315
HbA1c, % (SVR)
14/365
0.789
0.362–1.720
0.552
WBC, /μL (SVR)
15/399
1.000
0.999–1.000
0.081
Hemoglobin, g/dL (SVR)
15/400
0.894
0.633–1.260
0.522
Platelet, ×103/μL (SVR)
15/400
0.984
0.973–0.995
0.004
0.994
0.982–1.005
0.276
INR (SVR)
15/380
14.920
0.265–838
0.189
LS, m/s (TW0)
13/290
2.153
1.093–4.241
0.027
LS, m/s (SVR)
12/255
2.901
1.611–5.223
<0.001
LS, m/s (Y3PSVR)
14/369
3.208
1.631–6.306
0.001
3.980
2.085–7.597
<0.001
LS decline, % (from SVR to Y3PSVR)
11/239
0.380
0.031–4.669
0.450
APRI (TW0)
15/401
1.330
1.150–1.537
<0.001
APRI (SVR)
15/399
2.016
1.466–2.773
<0.001
FIB-4 (TW0)
15/401
1.303
1.162–1.462
<0.001
FIB-4 (SVR)
15/399
1.544
1.319–1.806
<0.001
n/n indicates the number of events and the sample size (cases with missing values were excluded; 118 cases were censored before the first event after Y3PSVR; 332 cases entered the multivariate analysis). Decline = (preceding value minus next values)/preceding value. AFP, α-fetoprotein; ALT, alanine aminotransferase; APRI, aspartate-aminotransferase-to-platelet ratio index; AST, aspartate aminotransferase; CI, confidence interval; eGFR, estimated glomerular filtration rate (Modification of Diet in Renal Disease formula); FIB-4, fibrosis-4 index; HbA1c, hemoglobin A1c; HCC, hepatocellular carcinoma; HCV, hepatitis C virus; HR, hazard ratio; INR, international normalized ratio; LRE, liver-related event; LS, liver stiffness; SVR, sustained virologic response (visit); TW0, treatment baseline; WBC, white blood cell; Y3PSVR, year 3 post-SVR.