Quantification of fibrosis progression in patients with chronic hepatitis C using a Markov model

The knowledge of fibrosis progression in chronic hepatitis C and the impact of new treatments on progression is limited by the number of available liver biopsies per patient. Moreover, liver biopsies identify a patient's stage of fibrosis at a given point in time, but cannot quantify the time spent in that stage nor the date of transition to that stage. This paper assesses the potential of Markov modelling to overcome these difficulties. The data from interferon‐treated (n=185) and untreated patients (n=102) are analysed to illustrate the power of this technique.

[1]  A. Valleron,et al.  Correlation between hepatitis C virus prevalence and hepatocellular carcinoma mortality in Europe , 1999, Journal of viral hepatitis.

[2]  M. Kojiro,et al.  Long‐term evolution of fibrosis from chronic hepatitis to cirrhosis in patients with hepatitis C: Morphometric analysis of repeated biopsies , 1997, Hepatology.

[3]  P. Bedossa,et al.  Intraobserver and Interobserver Variations in Liver Biopsy Interpretation in Patients with Chronic Hepatitis C , 1994 .

[4]  P. Bedossa,et al.  Natural history of liver fibrosis progression in patients with chronic hepatitis C , 1997, The Lancet.

[5]  R H Jones,et al.  Multi-state models and diabetic retinopathy. , 1995, Statistics in medicine.

[6]  A. Valleron,et al.  Modeling the hepatitis C virus epidemic in france , 1999, Hepatology.

[7]  A. Valleron,et al.  Estimated timing of mother-to-child human immunodeficiency virus type 1 (HIV-1) transmission by use of a Markov model. The HIV Infection in Newborns French Collaborative Study Group. , 1995, American journal of epidemiology.

[8]  I M Longini,et al.  The dynamics of CD4+ T-lymphocyte decline in HIV-infected individuals: a Markov modeling approach. , 1991, Journal of acquired immune deficiency syndromes.

[9]  Y. Yazdanpanah,et al.  Risk of hepatitis C virus transmission to surgeons and nurses from infected patients: model-based estimates in France. , 1999, Journal of hepatology.

[10]  William H. Press,et al.  Numerical recipes in C , 2002 .

[11]  F. Carnot,et al.  Predictive factors for development of cirrhosis in parenterally acquired chronic hepatitis C: a comparison between immunocompetent and immunocompromised patients. , 1998, Journal of hepatology.

[12]  C. Rouzioux,et al.  Timing of human immunodeficiency virus type 1 (HIV-1) transmission from mother to child: bayesian estimation using a mixture. , 1999, Statistics in medicine.

[13]  M. Vidaud,et al.  Modeling the impact of interferon alfa treatment on liver fibrosis progression in chronic hepatitis C: a dynamic view. The Multivirc Group. , 1999, Gastroenterology.