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Transient elastography: A non-invasive tool for assessing liver fibrosis in HIV/HCV patients

World Journal of Gastroenterology 2010年第41期16卷 5225-5232页

作者： Valentina Li Vecchi Maurizio Soresi Claudia Colomba Giovanni Mazzola pietro colletti Maurizio Mineo Paola Di Carlo Emanuele La Spada Giovanni Vizzini Giuseppe Montalto Department of Clinical Medicine and Emerging Pathologies University of Palermo Via del Vespro 141 90127 Palermo Italy Infectious Diseases Section Department of Health Promotion Sciences University of Palermo Via del Vespro 129 90127 Palermo Italy Department of Gastroenterology and Hepatology Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IsMeTT) University of Pittsburgh Medical Center Via Tricomi 1 90127 Palermo Italy

AIM: To assess the prevalence of advanced liver fibrosis (ALF) in human immunodeficiency virus (HIV), hepatitis C virus (HCV) and HIV/HCV patients using transient elastography, and to identify factors associated with ALF. METHODS: Between September 2008 and October 2009, 71 HIV mono-infected, 57 HIV/HCV co-infected and 53 HCV mono-infected patients on regular follow-up at our Center were enrolled in this study. Alcohol intake, the main parameters of liver function, presence of HCV-RNA, HIV-RNA, duration of highly active anti-retroviraltherapy (HAART) and CD4 cell count were recorded. ALF was defined as liver stiffness (LS) ≥ 9.5 kPa. To estimate liver fibrosis (LF) a further 2 reliable biochemical scores, aspartate aminotransferase platelet ratio index (APRI) and FIB-4, were also used. RESULTS: LS values of co-infected patients were higher than in either HIV or HCV mono-infected patients (χ 2M H = 4, P 9.5 kPa. There was no significant correlation between extent of LF and HAART exposure or duration of HAART exposure, in particular with specific dideoxynucleoside analogues. CONCLUSION: ALF was more frequent in co-infected than mono-infected patients. This result correlated with lower CD4 levels. Protectiv

关键词： Liver fibrosis Transient elastography Aspartate aminotransferase platelet ratio index FIB-4 test Fibrosis evaluation Human immunodeficiency virus infection Hepatitis C virus infection

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