Factors That Predict Response of Patients With Hepatitis B e Antigen–Positive Chronic Hepatitis B to Peginterferon-Alfa

Distribution of predicted probabilities of sustained response in patients with HBV genotypes A–D. Boxplots show the distribution of the predicted probabilities of sustained response, defined as HBeAg loss and HBV DNA less than 10,000 copies/mL at 6 months posttreatment, in patients with genotype A (n = 115), B (n = 166), C (n = 333), or D (n = 107).

PEG-IFN HBV treatment index. These nomograms can be used to obtain a patient-tailored predicted probability of sustained response in IFN-naive patients with genotypes A–D based on ALT level, HBV-DNA level, sex, and age. The probability of sustained response is calculated by drawing a vertical line to the top points axis for each of the 4 variables ALT, HBV DNA, age, and sex. The points for each variable then are summed and located on the total points axis, and a vertical line is projected from the total points axis to the bottom scale to get the predicted probability of sustained response. For example, a genotype C–infected woman (62 points), age 25 (67 points), with serum ALT level of 2.7 × ULN (25 points), and serum HBV-DNA level of 9.2 log₁₀ copies/mL (40 points) has a total score of 194 points, which converts to a probability of sustained response of 37%.

Flowcharts to easily obtain average predicted probabilities of sustained response in patients infected with HBV genotypes A–D. These flowcharts show the average predicted probability of sustained response depending on HBV genotype, ALT level (> or <2 × ULN), and HBV-DNA level (> or <9 log₁₀ copies/mL). For a precise estimate of the probability of sustained response in an individual patient, the nomograms in Figure 2 can be used.