Biochemical non-invasive assessment of liver fibrosis cannot replace biopsy in HIV-HCV coinfected patients
Journal Title: Annals of Hepatology - Year 2016, Vol 15, Issue 1
Abstract
Background and rationale. The liver biopsy has been considered the gold standard for the diagnosis and quantification of fibrosis. However, this method presents limitations. In addition, the non-invasive evaluation of liver fibrosis is a challenge. The aim of this study was to validate the fibrosis cirrhosis index (FCI) index in a cohort of human immunodeficiency virus (HIV)/hepatitis C virus (HCV) coinfected patients, and compare to AST/ALT ratio (AAR), AST to platelet ratio index (APRI) and FIB-4 scores, as a tool for the assessment of liver fibrosis in coinfected patients. Material and methods. Retrospective cross sectional study including 92 HIV-HCV coinfected patients evaluated in two reference centers for HIV treatment in the Public Health System in Southern Brazil. Patients who underwent liver biopsy for any indication and had concomitant laboratory data in the 3 months prior to liver biopsy, to allow the calculation of studied noninvasive markers (AAR, APRI, FIB-4 and FCI) were included. Results. APRI < 0.5 presents the higher specificity to detect no or minimal fibrosis, whereas APRI > 1.5 presents the best negative predictive value and FCI > 1.25 the best specificity to detect significant fibrosis. The values of noninvasive markers for each Metavir fibrosis stage showed statistically significant differences only for APRI. In conclusion, until better noninvasive markers for liver fibrosis are developed and validated for HIV-HCV coinfected patients, noninvasive serum markers should be used carefully in this population.
Authors and Affiliations
Dimas Kliemann, Fernando Wolff, Cristiane Tovo, Paulo Alencastro, Maria Ikeda, Ajácio Brandão, Nêmora Barcellos, Sandra Fuchs
Keywords
Related Articles
- EP ID EP78533
- DOI 10.5604/16652681.1184197
- Views 125
- Downloads 0
Genotype f prevails in Venezuelan urban patients with chronic hepatitis B
Hepatitis B virus (HBV) has been classified into 8 genotypes (A-H). Genotypes A, D and F have been identified in some South American countries, but in Venezuela studies have been more restricted to aboriginal communities...
Recreational physical activity is inversely associated with asymptomatic gallstones in adult Mexican women
Background and rationale. Epidemiologic research suggests that physical activity (PA) reduces the risk of chronic diseases including gallstones. Objective. This study explores the association between recreational physica...
Liver stiffness assessed by transient elastography in patients with β thalassaemia major
Rationale for the study. This cross-sectional multicenter study was conducted to investigate any difference in liver stiffness measurements (LSM), evaluated by transient elastography, between patients affected by β thal...
Massive avascular malformations causing life threatening portal hypertension
We present an unusual case of extensive avascular malformations (AVMs) causing non-cirrhotic portal hypertension. This phenomenon, though previously described, is a rare clinical entity which, in the setting of life thr...
Tenofovir-induced Fanconi syndrome in a patient with chronic hepatitis B monoinfection
Tenofovir disoproxil fumarate (TDF) is a nucleotide reverse transcriptase inhibitor indicated for treatment of patients with chronic hepatitis B virus (CHB) and human immunodeficiency virus (HIV) infections. Despite the...