Clinical significance of viral genotyping in patients with chronic hepatitis C and construction and validation of a risk prediction model for hepatitis C-related cirrhosis

YUAN Yi; QIU Luan-ning; WAN Xiao-tao; FU Wei-ping

doi:10.13820/j.cnki.gdyx.20250184

Abstract：Objective To analyze the clinical significance of viral genotyping in patients with chronic hepatitis C and to construct and validate a risk prediction model for hepatitis C-related cirrhosis using commonly used laboratory in-dicators.Methods Laboratory data were collected from 243 untreated chronic hepatitis C patients and 104 patients who had progressed from hepatitis C to cirrhosis between January 2022 and November 2024.Differences in age,sex,alanine aminotransferase(ALT),aspartate aminotransferase(AST),γ-glutamyl transferase(GGT),total bilirubin(TBIL),albumin(ALB),anti-HCV antibody,viral load,fibrinogen(FIB),D-dimer(DD),white blood cell count(WBC),absolute neutrophil count(NEU),and platelet count(PLT)were compared across different HCV genotypes.Data were split into a training set and validation set in a 7∶3 ratio.Univariate and multivariate logistic regression analyses were per-formed to identify risk factors for the progression to cirrhosis.A nomogram prediction model was developed using R soft-ware and validated.Results Among the 243 chronic hepatitis C patients,the age of patients with genotype 3b was signif-icantly lower than those with genotype 1b(P＜0.05).ALT levels in genotypes 3 a and 3 b were significantly higher than those in genotype 6a(P＜0.05),and ALT levels in genotype 3b were significantly higher than those in genotypes 1b and 2a(P＜0.05).AST levels in genotype 3b were significantly higher than in genotype 1b(P＜0.05).Multivariate logistic regression analysis in the training set identified ALT,TBIL,and DD as independent risk factors for cirrhosis progression.A nomogram was constructed based on these three predictors.The area under the receiver operating characteristic(ROC)curve(AUC)was 0.706(95％CI:0.631-0.782)in the training set and 0.829(95％CI:0.741-0.916)in the vali-dation set.The Hosmer-Lemeshow test yielded P=0.211 for the training set and P=0.824 for the validation set,indi-cating good calibration.Decision curve analysis(DCA)showed favorable clinical net benefit.Compared with the FIB-4 index,there was no significant difference in AUROC(Z=0.223,P=0.824).Conclusion The age and the extent of liver damage in patients with chronic hepatitis C are associated with different genotypes.The prediction model demonstrates good perform ance and may be useful for assessing the risk of progression to cirrhosis in patients with chronic hepatitis C.