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Progression of Liver Fibrosis in HIV/HCV Co-Infection: A Comparison between Non-Invasive Assessment Methods and Liver Biopsy.

Schmid P, Bregenzer A, Huber M, Rauch A, Jochum W, Müllhaupt B, Vernazza P, Opravil M, Weber R, Swiss HIV Cohort Stu - PLoS ONE (2015)

Bottom Line: TE, APRI and Fibrotest did not significantly change during follow-up.Fibrotest results did not change over 3 years.NITs did not change significantly during a follow-up of three years, suggesting slow liver disease progression in a majority of HIV/HCV co-infected persons on antiretroviral therapy.

View Article: PubMed Central - PubMed

Affiliation: Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.

ABSTRACT

Objectives: To evaluate the diagnostic performance of seven non-invasive tests (NITs) of liver fibrosis and to assess fibrosis progression over time in HIV/HCV co-infected patients.

Methods: Transient elastography (TE) and six blood tests were compared to histopathological fibrosis stage (METAVIR). Participants were followed over three years with NITs at yearly intervals.

Results: Area under the receiver operating characteristic curve (AUROC) for significant fibrosis (> = F2) in 105 participants was highest for TE (0.85), followed by FIB-4 (0.77), ELF-Test (0.77), APRI (0.76), Fibrotest (0.75), hyaluronic acid (0.70), and Hepascore (0.68). AUROC for cirrhosis (F4) was 0.97 for TE followed by FIB-4 (0.91), APRI (0.89), Fibrotest (0.84), Hepascore (0.82), ELF-Test (0.82), and hyaluronic acid (0.79). A three year follow-up was completed by 87 participants, all on antiretroviral therapy and in 20 patients who completed HCV treatment (9 with sustained virologic response). TE, APRI and Fibrotest did not significantly change during follow-up. There was weak evidence for an increase of FIB-4 (mean increase: 0.22, p = 0.07). 42 participants had a second liver biopsy: Among 38 participants with F0-F3 at baseline, 10 were progessors (1-stage increase in fibrosis, 8 participants; 2-stage, 1; 3-stage, 1). Among progressors, mean increase in TE was 3.35 kPa, in APRI 0.36, and in FIB-4 0.75. Fibrotest results did not change over 3 years.

Conclusion: TE was the best NIT for liver fibrosis staging in HIV/HCV co-infected patients. APRI-Score, FIB-4 Index, Fibrotest, and ELF-Test were less reliable. Routinely available APRI and FIB-4 performed as good as more expensive tests. NITs did not change significantly during a follow-up of three years, suggesting slow liver disease progression in a majority of HIV/HCV co-infected persons on antiretroviral therapy.

No MeSH data available.


Related in: MedlinePlus

Change in transient elastography values (kPa) over time (3 years).
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pone.0138838.g005: Change in transient elastography values (kPa) over time (3 years).

Mentions: Change in TE is shown in Fig 5. Mean TE (n = 82) was 8.2 kPA (range 3.0–34.8) at baseline and 7.9 kPA (range 3.4–36.3) after 3 years. Mean APRI-Score (n = 85) was 0.85 (range 0.10–4.16) at baseline and 0.81 (range 0.05–5.77) after 3 years. Mean FIB-4-Score (n = 85) was 1.74 (range 0.24–7.40) at baseline and 1.95 (range 0.27–7.73) after 3 years. Mean Fibrotest (n = 85) was 0.56 (range 0.04–0.97) at baseline and 0.55 (range 0.04–0.97) after 3 years. Liver-stiffness, APRI and Fibrotest did not significantly change between baseline and follow-up examination after 3 years. There was weak evidence (p = 0.07) for an increase of FIB-4 (mean difference: 0.22 (95% CI: -0.02 to 0.45)).


Progression of Liver Fibrosis in HIV/HCV Co-Infection: A Comparison between Non-Invasive Assessment Methods and Liver Biopsy.

Schmid P, Bregenzer A, Huber M, Rauch A, Jochum W, Müllhaupt B, Vernazza P, Opravil M, Weber R, Swiss HIV Cohort Stu - PLoS ONE (2015)

Change in transient elastography values (kPa) over time (3 years).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4587859&req=5

pone.0138838.g005: Change in transient elastography values (kPa) over time (3 years).
Mentions: Change in TE is shown in Fig 5. Mean TE (n = 82) was 8.2 kPA (range 3.0–34.8) at baseline and 7.9 kPA (range 3.4–36.3) after 3 years. Mean APRI-Score (n = 85) was 0.85 (range 0.10–4.16) at baseline and 0.81 (range 0.05–5.77) after 3 years. Mean FIB-4-Score (n = 85) was 1.74 (range 0.24–7.40) at baseline and 1.95 (range 0.27–7.73) after 3 years. Mean Fibrotest (n = 85) was 0.56 (range 0.04–0.97) at baseline and 0.55 (range 0.04–0.97) after 3 years. Liver-stiffness, APRI and Fibrotest did not significantly change between baseline and follow-up examination after 3 years. There was weak evidence (p = 0.07) for an increase of FIB-4 (mean difference: 0.22 (95% CI: -0.02 to 0.45)).

Bottom Line: TE, APRI and Fibrotest did not significantly change during follow-up.Fibrotest results did not change over 3 years.NITs did not change significantly during a follow-up of three years, suggesting slow liver disease progression in a majority of HIV/HCV co-infected persons on antiretroviral therapy.

View Article: PubMed Central - PubMed

Affiliation: Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.

ABSTRACT

Objectives: To evaluate the diagnostic performance of seven non-invasive tests (NITs) of liver fibrosis and to assess fibrosis progression over time in HIV/HCV co-infected patients.

Methods: Transient elastography (TE) and six blood tests were compared to histopathological fibrosis stage (METAVIR). Participants were followed over three years with NITs at yearly intervals.

Results: Area under the receiver operating characteristic curve (AUROC) for significant fibrosis (> = F2) in 105 participants was highest for TE (0.85), followed by FIB-4 (0.77), ELF-Test (0.77), APRI (0.76), Fibrotest (0.75), hyaluronic acid (0.70), and Hepascore (0.68). AUROC for cirrhosis (F4) was 0.97 for TE followed by FIB-4 (0.91), APRI (0.89), Fibrotest (0.84), Hepascore (0.82), ELF-Test (0.82), and hyaluronic acid (0.79). A three year follow-up was completed by 87 participants, all on antiretroviral therapy and in 20 patients who completed HCV treatment (9 with sustained virologic response). TE, APRI and Fibrotest did not significantly change during follow-up. There was weak evidence for an increase of FIB-4 (mean increase: 0.22, p = 0.07). 42 participants had a second liver biopsy: Among 38 participants with F0-F3 at baseline, 10 were progessors (1-stage increase in fibrosis, 8 participants; 2-stage, 1; 3-stage, 1). Among progressors, mean increase in TE was 3.35 kPa, in APRI 0.36, and in FIB-4 0.75. Fibrotest results did not change over 3 years.

Conclusion: TE was the best NIT for liver fibrosis staging in HIV/HCV co-infected patients. APRI-Score, FIB-4 Index, Fibrotest, and ELF-Test were less reliable. Routinely available APRI and FIB-4 performed as good as more expensive tests. NITs did not change significantly during a follow-up of three years, suggesting slow liver disease progression in a majority of HIV/HCV co-infected persons on antiretroviral therapy.

No MeSH data available.


Related in: MedlinePlus