Machine-learning methodologies to predict disease progression in chronic hepatitis B in Africa

Background: Little is known about the determinants of disease progression among African patients with chronic HBV infection. Methods: We used machine-learning models with longitudinal data to establish predictive algorithms in a well-characterized cohort of Ethiopian HBV-infected patients without baseline liver fibrosis. Disease progression was defined as an increase in liver stiffness to >7.9 kPa or initiation of treatment based on meeting the eligibility criteria. Results: Twenty-four of 551 patients (4.4%) experienced disease progression after a median follow-up time of 69 months. A random forest model based on a combination of available laboratory tests (standard hematology and biochemistry) demonstrated the best predictive properties with the AUROC ranging from 0.82 to 0.88. Conclusion: We conclude that combined metrics based on simple and available laboratory tests had good predictive properties and should be explored further in larger HBV cohorts.